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-Tft-O fFEEKS
^i^srERS OF SHEDICI^E
EDITED BY
ERNEST HART, D.C.L
(Homines AD deos nulla inueII
iPROPIUS ACCEDUNT QUXM
SALUTEM HOMINIBUS DANDO'.
Masters of Medicine
Title.
John Hunter
William Harvey
Sir James Simpson
Edward Jenner .
Hermann von Helmholtz
William Stokes
Claude Bernard
Sir Benjamin Brodie
Thomas Sydenham
Vesalius
Author.
Stephe?i Paget
D^Jrcy Power
H. Laing Gordon
Ernest Hart
yohn G. McKendrick
Sir JFilliam Stokes
Michael Foster
Tifuothy Holmes
J. F. Payne
C. Louis Taylor
M
ASTERS
OF
EDICINE
SIR JAMES YOUNG SIMPSON
AND CHLOROFORM
^mm^
hi lA^y^Hj v\S)
Sir James Young
Simpson
AND
CHLOROFORM
(1811— 1870)
{<i>\
BY
H. Laing Gordon
:j^£pf roRK
LONGMANS, GREEN & CO
91 & 93, FIFTH AVENUE
1897
Copyright by T. Fisher Unwin^ l%(^']^for Great Britai?i
and Longmans Green ^ Co. for the
United States of America
To
PROFESSOR ALEXANDER RUSSELL SIMPSON
" Hini by the hand clear Nature took,
Dearest Nature, strong and kind."
Ralph Waldo Emerdon.
" When Nature has work to be done, she creates a genius to do it."
Id.
PREFACE
I HAVE endeavoured to condense the vast amount
of matter w^hich has been written concerning this
Master of Medicine and his work into the form of
a readable narrative, and to represent him in his
social and intellectual environment in accordance
with the object of this Series. The selections from
his own writings illustrate as far as possible his
versatility and many-sided character. I have chosen
for quotation out of the num.erous sketches and
memoirs of him those written from undoubted
knowledge of the man.
I am indebted especially to Professor A. R. Simpson
for kind advice, to Mr. Cuthbertson of the Edinburgh
University Library for useful help, to Mr. C. Louis
Taylor for valuable criticism, and to my wife for
assistance in research and compilation. I have also
to thank those friends who from time to time have
favoured me with personal reminiscences of Sir James.
The following are the chief works, in addition to
Simpson's own writings, from which my information has
ix
PREFACE
been drawn : — ( i ) " The Jubilee of Anaesthetic Mid-
wifery" ; (2) "KeiUer and Crede " ; (3) "History
of the Chair of Midwifery in the University of Edin-
burgh," being addresses by Professor A. R. Simpson ;
(4) Miss Eve B. Simpson's "Sir James Simpson";
and her (5) "Dogs of other Days;" (6) "Twenty
Years and their Lesson ; a Retrospect and Review "
[Scots Observer, 1891); (7) Dr. Duns's "Memoir
of Sir J. Y. Simpson"; (8) Professor Gusserow's
" Zur Erinnerung an Sir J. Y. Simpson"; (9) Mr.
Cuthbertson's "Student's Pilgrimage"; (10) "The
Story of Edinburgh University," by Sir A. Grant ;
(11) "The Life of Sir Robert Christison " ; (12)
"The Life of Robert Knox"; and numerous back
numbers of the Century Magazine, the Lancet, the
British Medical Journal, the Medical Times and
Gazette, the Edinburgh Medical Journal, he, &c.
Forest Hill, October, 1897.
CONTENTS
PAGE
I. BIRTH AND CHILDHOOD (181I-1825) . I
II. STUDENT DAYS (1825-1830) . . 1 7
III. FURTHER STUDIES (183O-1835) . . 36
IV. EARLY PRACTICE AND PROFESSORSHIP
(1835-1840) 52
V. PROFESSOR AND PHYSICIAN (184O-1847) 66
VI. THE DISCOVERY OF ANAESTHETICS (1844-
1847) 88
VII. THE FIGHT FOR ANESTHESIA (1847
onwards) . . . . .Ill
VIII. HOME LIFE CONTROVERSIES . . -133
IX. ARCHAEOLOGY— PRACTICE . . . I52
X. PERSONAL PROFESSORIAL — PROFESSIONAL . I 64
xi
PAGE
CONTENTS
CHAP.
XI. FURTHER REFORMS — HONOURS . . i86
XII. FAILING HEALTH DEATH . . . 202
APPENDIX . . , . . .22?
INDEX . . . , . , ^ 227
Xll
SIR JAMES SIMPSON
CHAPTER I
Birth and Childhood.
1811-1825
The state of the healing art at Simpson's birth — Birthplace — Family
superstitions — His father's bakery — His mother's Huguenot descent
— Commencement of schooldays — Natural and antiquarian features
of Bathgate district — The village hand-loom weavers as antiqua-
rians and naturalists — His interest in Nature and craving for Icnow-
leilge — Brotliers' and sister's care for him — Size of his head —
Village doctor's record of his birth — Schooldays cease at age of
fou)teen — Influence of his environment in developing his character.
JAMES YOUNG SIMPSON, who will ever be
remembered as the discoverer of the pain-annul-
lijig power of chloroform, was born in tlie year
1 811, at a period when tliere was room for a hero in
the practice of the heahng art in the British Islands.
It is true that in the seventeenth century Han'ey
had laid bare the great fact of the circulation of the
blood and the practical Thomas Sydenham had
swept aside the highly empirical systems and theories
SIR JAMES SIMPSON
of medicine which had successively supplanted each
other since Hippocrates first taught, and urged men to
found their knowledge upon what they actually saw —
on observation and experiment ; and that in the
eighteenth century men like Cheyne, Heberden,
Cullen, and the wonderful Jenner had appreciably
assisted in developing medicine at the same time
that Hunter was raising surgery nearer to the level
of a science. But even while Simpson was growing
out of childhood all the powers of such profes-
sional giants as Bright, Addison, Abernethy, Astley
Cooper, and Charles Bell, were insufficient to dispel
the massive cloud of mystery and superstition which
enveloped the practice of both medicine and surgery
iji this country and obscured whatever there was of
truth in the teaching of these men.
In the first decade of two of this century the medical
profession had not yet entirely abandoned the use of
the golden-headed cane, nor had what Oliver Wendell
Holmes calls the solemn farce of overdrugging yet
ceased. " Humours," " impostumes," " iliac passions,"
and such like were still spoken of — terms now heard
only amongst country-folks in remote districts and
that rarely, or encountered in curious old medical pub-
lications. Messes and abominations, prepared by the
apothecaries according to more or less secret recipes
handed down through the Middle Ages, were swallowed
in good faith ; blood-letting was still a panacea ; and
such remedies as that of holding a live puppy to the
2
BIRTH AND CHILDHOOD, 1811-1825
body for the relief of colic still had their professional
advocates, but happily a decreasing number ; whilst
those pains
". . . In the hour,
When the veil of the body we feel
Rent round us — while torments reveal
The motherhood's advent in power "
— pains which Simpson was the first truly to relieve by
his application of anaesthetics, were gravely said to be
alleviated by the swallowing of a concoction of white
onions and oil. Surgery was no doubt ahead of
medicine ; but the early surgical records of this century
have little more than a curious interest to modern
practitioners. Operations entirely unknown to our
professional forefathers less than a century ago are
now performed in safety daily. Such mysterious
diseases as " icteric irritative fever " and " acute
sinking" after operations, dreaded then with the fear
that is always inspired by unseen or ill-understood
dangers, have vanished before the progress of modern
science in which the introduction of anaesthesia was
the first great step.
The practice of the branch of medicine which
Simpson made so peculiarly his own — that of ob-
stetrics— originally in the hands of women only, had
been fiercely contested for by the two sexes during
two centuries, and such was the feeling against man-
midwives in Scotland that the dispute had scarcely
ceased at Simpson's birth. The stronger sex, however,
3
SIR JAMES SIMPSON
was then at last asserting its superiority, and to be an
accoucheur was beginning to be considered after all
as worthy of a gentleman. The despised art was
preparing for its renaissance.
Simpson grew to manhood whilst science, aided by
precise methods of accurate observation, was shedding
new light upon physic, surgery, and obstetrics. In
fulfilling his great part in establishing the healing art
on a firm scientific basis, Simpson encountered the full
force of the ignorance and prejudice of his day both
within and without his profession. It was, perhaps,
fortunate that he was brought up in a small village
and in a rank of life where he would meet from
his earliest days with many superstitious beliefs and
practices, strange and utterly irrational. A mind such
as his would meet, reason, and experiment these out of
existence. Probably through these circumstances he
conceived the taste for archaeology and antiquarian
research which were his recreation in later years ; but,
what was more important, he gained also some train-
ing for the struggle with ignorance, untruth, and
irrationalism, into which he threw with his eager
vigour the whole strength of his manhood.
Simpson was born in the village of Bathgate, in
Linlithgowshire, where his father, David Simpson,
was the local baker. David's father, who died at the
ripe age of ninety-one a few years after James's birth,
was the descendant of a line of small hard-working
farmers, who added to his work and his profit the
4
BIRTH AND CHILDHOOD, 1811-1825
practice of farriery. Although modern science has,
by the aid of bacteriology, proved such practitioners
of the rough veterinary medicine of the day to have
been right in ascribing to unseen influences many of
the diseases of animals which they found themselves
powerless to check, the methods they employed for
treatment when what they called witchcraft was at
work scarcely have the support of present-day practi-
tioners. In one of his addresses upon archaeology
Simpson records hov/ his grandfather ordered and his
own father took part in the burial alive of a cow in
order to appease the evil spirit which was spreading
the plague of murrain with fatal effect. And the
older gentleman was known to have had more than
one serious encounter with a witch. On one occa-
sion an old beggar woman, who plied her calling in
quite an original method — that of being wheeled in a
barrow from farm to farm — hurled curses at old
Simpson for ordering a servant to v/heel her from his
house on to her next calling-place, and vowed an
awful vengeance on his family if he did not replace
the servant with one of his stalwart sons. The
farmer recollected that an ill event had followed the
old woman's last visit, and quickly drew a sharp flint
from his pocket and made a gash across her forehead
with it. " Ah," he exclaimed, " I see what ye're noo,
ye auld witch ; but I've scored ye aboon the braith
and my house is safe."
Simpson noted these and many other curious prac-
5
SIR JAMES SIMPSON
tices and beliefs, and afterwards pointed out in one of
his addresses that they were probably, for the most
part, relics of the pagan creeds and customs of our
ancestors. He urged the making of a collection of
the folk-lore of Scotland, ere it utterly disappeared
before the march of modern civilisation, and suggested
that, perhaps, some archaeological Cuvier might one
day be able to re-construct from these mythological
fragments distinct pictures of the heathen practices,
rites, and faiths of our forefathers.
In his early boyhood he listened to many stories of
local and family superstitions told to him with all the
earnestness of a firm believer by his father. He him-
self was the object of superstitious admiration to the
simple villagers all through his boyhood, and they
freely foretold- great deeds from him in later years ;
for he was a seventh son, and the good luck which
seventh sons were supposed to bring had appeared in
the family soon after his birth. Up to the day on
which James first saw the light, June 7, 181 1, the
baker's business had been going steadily from bad to
worse, and the shop books showed that on that very
day the lowest depths were reached. The baker,
David Simpson, seems to have been curiously lacking
in business method, although he was a hard-working
man. But after James's birth he wisely interested his
wife in his affairs, with the result that she energetically
and successfully bestirred herself to recoup their fallen
fortunes. Mrs. Simpson was directly descended from
6
BIRTH AND CHILDHOOD, 1811-1825
a fugitive Huguenot family, settled for many years on
a farm near Bathgate, and intermarried with well-
known families. Through her, indeed, Simpson claimed
a distant relationship with the national hero. Sir William
Wallace. The cares of her family and the strain of
managing the increasing baker's business proved too
much for her always delicate constitution, and she died
when James was only nine years old. There is no
doubt that the youngest child and favourite son had an
unusually large share of his mother's society during those
years ; he was a peculiarly attractive child, " a rosy
bairn wi' laughin' mou' and dimpled cheeks," and his
manner, even when he was little more than an infant,
was quiet and affectionate. When physical sufferings
overtook the mother, the child's quiet sympathy and
engaging manner helped and comforted her. Her own
nature was bright, vivacious, and energetic, quick to
think and prompt to act ; and she was full of love,
sympathy, and piety. These maternal traits influenced
the youth, and added a soft, refined — delicately refined
— tone to the paternal influence, whence he received
self-reliance and habits of persevering industry.
The boy's school-life began at the age of four
years. The orthodox learning came very easily to
him ; he entered into both work and play so whole-
heartedly that he at once became known as the " wise
wean," and was at the same time ever sought after by
his school-mates as a companion in out-door sports.
The parish schoolmaster was one James Taylor, who
7
SIR JAMES SIMPSON
had considerable ability for the post, and encouraged
his pupils by kindly personal interest to develop affec-
tion for learning. But for Simpson there were other
teachers and greater subjects for study in the country-
side around Bathgate. The district was full of rich
treasures for the field naturalist and for the anti-
quarian. Bathgate lies between the Firth of Forth
and the Pentland Hills, in a geologically varied
district, with a varied and abundant flora and fauna —
more so in those days when Bathgate was a small
village of hand-loom weavers than latterly, when it
was a thriving little town, the centre of a coal, shale,
and ironstone mining industry. The archaeological
features of the neighbourhood were full of interest.
There was the famous " Catstane," of Kirkliston,
which had p-uzzled antiquarians even before the
establishment of the Scots Society in 1780, and at
Kipps was one of the few remaining cromlechs —
and that a ruined one — in Scotland ; whilst the line
of the Roman wall between the Firth of Forth and
the Clyde was not far distant. There were traces of
a Cistercian monastery founded by David I., and
various hills and fields and caves were associated with
the names of Sir William Wallace, Robert Bruce,
and King Edward I.
Simpson thoroughly familiarised himself in boyhood
with the natural features, as well as with the antiquarian
objects in the district. He continued to investigate
them during his vacations when a student at Edin-
8
BIRTH AND CHILDHOOD, 1811-1825
burgh University, and rendered the neighbourhood
famous archasologically by masterly monographs written
when he was at the height of his fame. Amongst the
village hand-loom weavers, a race of peculiarly obser-
vant and intelligent men, there were some who studied
both the antiquarian objects and the natural history of
Linhthgowshire. Simpson used to speak of one man,
a daily labourer at the loom, who was able to write,
in correct Latin, an accurate description of any plant
or animal brought before him, although his earnings
at the loom never amounted to nfty pounds a year.
These men thoroughly enjoyed the evident interest of
the " young philosopher " in their discussions and
demonstrations, at the same time kindly directing his
mind towards the simple, painstaking, true methods of
observing and reflecting upon nature. There was no
lack of change in his environment for him ; his
interest in natural phenomena was roused and kept
alive during his drives round the countryside delivering
bread to the farmers and cottagers, or in occasional
visits to his parents' relations. He daily took his turn
behind the shop counter, reading, writing, or drawing
in the interval of waiting for customers. He trained
himself to read or do his school lessons as readily in a
roomful of romping children as in the quiet of the
bedroom. - It has been said that he never knew an
idle moment from the day of his birth onwards, and
his was such an indomitable and persevering energy
that the remark is no exaggeration. But the pathway
SIR JAMES SIMPSON
to greatness was made specially smooth for James
Simpson. He was set upon it, and protected in his
childhood, and guided in his youth, with the one
definite object always in view. The Simpson family
as well as the whole Bathgate community, took it for
granted that eminence was to be his in whatever walk
of life he entered seriously upon. His sister Mary and
his brother Alexander looked upon him as a special
care ; the former watched over him as a mother, and
the latter helped him in the ups and downs of boyhood,
just as he constantly stood by him throughout the
difficult days of his later career. It had always been
a custom in Scots families of humble rank that one
child, either from the exhibition of a natural aptitude,
or through the ambition of the parents, was singled
out to receive the advantages of a fuller education
such as is within the reach of every able lad in Scot-
land. Honour and glory would thus be brought to
the family, greatest of all if from the pulpit, while the
less favoured members of the family would plod on in
the same sphere of life as their parents. The world
owes a great deal to the Simpsons, and particularly to
Alexander, who cheerfully seconded their father's
efforts to help forward their young brother, without
a suspicion of jealousy. They knew he would be
great some day, and therein they looked for their
reward.
Happily there were ample means for all their
requirements derived from the now prosperous bakery.
10
BIRTH AND CHILDHOOD, 1811-1825
The money was kept in one drawer, the till where
the shop earnings were placed. All the household
were free to draw thence supplies for their ordinary-
wants, James without stint ; and he alone was
exempted from the condition that he who profited
must also contribute by the sweat of his brow. The
boy took very full advantage of his fortunate circum-
stances and drank deeply of all the knowledge that
came near and ever hunted for more. With each
succeeding year the craving to know, and to know
thoroughly, became more and more his ruling passion ;
by the time his schooldays were over it had gained
complete mastery over him ; happily for the human
race Providence had so endowed him that when
knowledge had come wisdom did not linger.
He was never in anv way led away by the temp-
tations that no doubt beset every boy in a village
of hard-drinkers such as Bathgate was in his youth.
Alexander took pains to warn him — " Others may
do this, Jamie, but it would break all our hearts
and blast all your prospects were you to do it," he
said. It was not necessary to make appeals to
James to work and fulfil the family predictions ; he
was as firmly determined to be great as they were sure
he would be. He never forgot how much he owed to
the loving help of his family, and to the fact that he
was the youngest son growing up at a time when the
family struggles were fairly over ; when instead of its
being an effort for the parents to provide the necessary
II
SIR JAMES SIMPSON
funds for his education, the shop-till was well filled
and the elder brothers and the loving sister were at
hand eagerly willing to help. In student days when
struggles came and the path seemed dark and beset
with dangers, the knowledge of the firm faith in his
powers of the family at home and of the scarcely
smaller faith of the weavers, was a powerful incentive
in the moments when he required any other than that
of the spirit within him.
We cannot feel otherwise than thankful that up to
the age of fourteen, when his schooldays ended, he
had access to but a limited stock of literature where-
with to gratify his hunger for knowledge. To satisfy
his appetite he was driven into the fields and the
forests ; every sense was stimulated, and became
developed through repeated use. Thus he laid the
foundation of his phenomenal faculty of rapid and
accurate observation, and of his no less phenomenal
memory.
His imagination was fed with the legends of the
district and tales of his remote moss-trooper ancestors
told to him of an evening by his father. Though
happily saved from being a bookworm to the ex-
clusion of sounder means for acquiring knowledge, he
devoured and digested every scrap of literature which
came in his way. Like all Scots children of his class
he learnt his Bible thoroughly from end to end — a
knowledge which served him well in later years.
Shakespeare followed the Bible in his own review or
12
BIRTH AND CHILDHOOD, 1811-1825
his favourite reading as a boy ; but a gazetteer or an
almanac was quite as acceptable. His taste was for
solid fact — fact which he could learn and put to the
test ; thus the great open book of Nature was the
attraction he most readily yielded to. But nothing
in book form ever came amiss to him ; if between the
covers there was useful information to be had, Simpson
extracted it and stored it away in his capacious brain.
The unusually large size of his head, a source of
admiration in manhood, was in childhood an object of
wonder to observers. In manhood he wore his hair
in long locks, and this was apparently his habit in
boyhood. Once a strange barber cut his hair so close
that his brother took upon himself to go and rebuke
the man. "The callant had suck a muckle head,"
was the retort, " I was doin' my best to mak' it look
respectable." A close-cropped head gave altogether a
too sportive appearance to the " young philosopher "
in the eyes of the watchful elder brother.
There is no evidence that Simpson displayed in his
schooldays any special leaning towards the medical
profession ; it cannot be reasonably urged that his
grandfather's rough skill in the treatment of animals
fostered any medical tendency in him, for James was
but five years old when the old man died. Even had
he been of an age to understand them, the methods
employed would have scarcely recommended them-
selves to a youth of Simpson's nature, sufficiently to
raise a spirit of emulation within him. It is also not
13
SIR JAMES SIMPSON
recorded that the village doctor took any special
interest in the boy or brought any influence to bear
upon him ; although his note-book thus gives the
earliest record of the future prince of obstetricians : —
275. — June 7. Simpson, David, baker, Bathgate.
Wife, Mary Jarvie. JE. 40. 8th child, son.
Natus 8 o'clock. IJti venieham natus. Paid
I OS. 6d.
James displayed his superiority so decidedly in the
village school that w^hen he reached the age of fourteen
it was decided to send him to Edinburgh University
without further waste of time. It was no unusual
age for boys to commence their University career
in Scotland. There was no secondary education
in the Scots provinces, but instruction intermediate
between that of the parish school and what is
ordinarily known as University education was given
within the walls of the University itself. Boys of
humble rank who aspired to a profession v/ere sent up,
as indeed many still are, at the age of fourteen or
fifteen, to attend these junior Arts classes in which
this instruction was, and still is, im.parted. The
University was crowded with schoolboys of all ranks
of life gathered together from town and country,
and consisted of nothing more than a collection of
class-rooms devoted to the giving of instruction in
lecture form. This stepping-stone of junior classes
BIRTH AND CHILDHOOD, 1811-1825
threw open the higher education to hundreds of
youths w]iose equals in England had no such ad-
vantage at that time. Scots University education
besides being thorough was decidedly clieap, so that
the cliurch, law, and medicine received many recruits
from the class out of which Simpson was drawn.
His envii"onmejit up to the age of fourteen was well
calculated to train him for the great work that lay
before him. The legends of the district, and the
sight of the objects of archaeological interest which he
came across in his rambles out of school hours, were
powerful stimuli to his sensations ; whilst tlie accurate
observation of natural phenomena in field and hedge
which the kindly interested weavers helped him to,
was also a valuable educative influence. It is probable
that his senses received much of the training wliich
was to lead to his ultimately being tlie greatest
physician of his day by these means, rather than from
the instruction imparted to him in the village school,
or derived by liim independently from the books that
came in his way. It was undoubtedly a fortunate
circumstajice that he was born and bred in aji out-
of-the-way country district, where he drew his lessons
from Nature and the phenomena which lay round
him, rather than in a great city where he would have
been educated on the stereotyped orthodox system.
When we look further back, asking why he saw
sermons in stones and books in the running brooks,
to which the bulk of his schoolfellows were entirely
^5
SIR JAMES SIMPSON
blind, we are bound to confess that we find no satis-
factory answer in his family history, to which it is
customary to look for an explanation of such
tendencies. Heredity played no great part in making
Simpson great ; from the paternal side there was
imparted to him a vigorous physique ; from his
mother he received the bright, happy, sympathetic, and
alert disposition, which descended through her from
his French ancestors. He was provided with a brain
of marvellous quality and phenomenal size. But it
was the environment which acted upon this brain
and brought out the capacities born in Jiim without
any apparent hereditary bias, and which might have
remained entirely lateiit under less favourable cir-
cumstances. No small part of the development v/as
due to the people among whom he lived ; a race
of men accustomed to' rely upon their senses which
were always with them, rather than upon books
which they seldom saw, even if they were able to read
them J and to observe not only all that lay around
them, but also the characteristics of their fellow-
men with whom they were brought into contact —
the close contact of different classes which obtains
in village and rural life. Simpson was taught to
study Nature whether in field or fellow - creature
first, and the knowledge and opinions of men as
expressed in books afterwards.
i6
CHAPTER II
Student Days, i 825-1 830.
Visit Lo fidinburgli— Sent to the University — Takes the Arts classes-
Gains a bursary — Influence of MacArthur antt Reid — Robert Knox
the anatomist — The Burke and Hare murders — Superiority of tlie
extra-mural teachers of the day — Edinburgh an intellectual centre
^University life — His mode of living asi student — Apprenticed
to a chemist — Studies surgery under Liston — Regularly fnlis asleep
in the obstetric class — Influence of his teachers — Verse writing —
Description of the mcilical student of the day — Vacation work —
Death of liis father — Obtains qualification lo practice at the age of
eighteen.
ALTHOUGH Edinburgh was only eighteen
miles from Bathgate, Simpson visited it only
once as a schoolboy ; probably he walked all the way,
for railroads were as yet unknown and it was not a
lojig walk for a country-bred vigorous youth. He
exercised his already formed habit of noting objects of
interest during this great event in his boyhood, and in
his journal there are copies of old inscriptions from
tombs in the famous Greyfriars' Churchyard to which
lie made his pilgrimage.
11 c
SIR JAMES SIMPSON
The boy's nearest and dearest ambition was to
become a student at " the College," as Edinburgh
University was familiarly termed. It received en-
couragement in the periodical return to the village of
elder boys who had gone up before him. He was
specially struck, and afterwards stimulated, by the
appearance of one John Reid, his senior by two years,
and his former companion in many a country ramble,
who came back for the vacations smartened up both
physically and mentally by the new life.
Although the collegiate life characteristic of Oxford
was unkjiown in Scots Universities, there was social
intercourse amongst the boys very different from
that of the village. The ajicient Edinburgh Uni-
versity attracted students from all parts of the world,
mostly for the medical curriculum, but many preceded
the professional course with a yeai- or two's attend-
ance on the Arts classes ; and it was usual for young
Englishmen of good family to spend a session at Edin-
burgh before going to Oxford or Cambridge. Pro-
bably before he ejitered the medical classes, Simpson
rubbed shoulders with lads of all ranks from home,
and abroad. Pillans was at this time the Professor of
Humajiity, Wallace held the chair of Mathematics,
John Wilson — better known as Christopher North —
that of Moral Philosophy, and Dunbar was Professor
of Greek. Wallace had begun life as a bookbinder's
apprentice, and Dunbar had risen from being a
gardener ; the example of these men under whose
i8
STUDENT DAYS, 1825-1830
influence he was brought encouraged the baker's son
to go and do likewise.
The family had sent him oflF to the College with
the mission to be famous, and he was beginning only
in an orthodox fashion when he entered himself for the
curriculum in Arts. It had been easy for him, with
his magnificent brain power, to stand dux of the
village school over the ordinary village youth ; but
here, in Edinburgh, he was brought into competition
with the picked boys from other country schools, and
intellectually eager youths from town schools where
the course of instruction was such as more easily to
lead to early University success than that of the
Bathgate parish school. At first he found difficulty
and desponded. The keen observer with senses all
alert was dashed to find so much of the College life to
which he had so eagerly looked forward only a magni-
fied repetition of the dull school routine. But he was
too intent on ultimate success to be repulsed by his
initial disappointment, and soon brought his mind into
adjustment with the circumstances he found himself
in, reserving leisure time and vacations for the exercise
of his faculties as he most loved to exercise them.
He did not persevere in the Arts course after he found
his tastes led him to other studies ; he did not trouble
to obtain the Master of Arts degree, which was then
conferred in a very lax manner ; probably he saw its
worthlessness, for it was not until the passing of the
Scots Universities Act in 1858 that this degree became
19
SIR JAMES SIMPSON
really valuable. He recognised, however, the value
of laying a good foundation of general know^ledge ;
w^ithout straining after any distinction he acquitted
himself creditably in all his classes. In the second
year of the curriculum he won one of the numerous
small bursaries of the value of ^lO a year, for which
logic was one of the chief subjects of examination ;
but as candidates were restricted to those who pos-
sessed either the name of the founder, Stewart, or that
of his wife, Simpson, the competition was not
particularly severe. His individuality and natural
straightforwardness attracted the attention of some
of his professors. The boldness of his original essays
provided them with food for comment in a manner
dear to the professorial heart.
The Arts curriculum served him usefully in helping
to develop a literary style and in teaching him how
best to express his vigorous thoughts, as well as in
strengthening his knowledge of Latin and Greek.
According to the record preserved on his class certifi-
cates he worked attentively and diligently ; but the
mere fact that he did not excel is sufficient proof that
he did not make an attempt.
During his Arts course Simpson lodged at No. i,
Adam Street, along with the John Reid already men-
- tioned, who was now a medical student, and with a
Mr. MacArthur, who had been a junior master at the
Bathgate school, but had now also commenced to
study medicine. MacArthur was a man of dogged
20
STUDENT DAYS, 1825-1830
determination ; he urged Simpson to persist with his
Arts course when his spirit seemed to rebel against it,
and so long as they were together seems to have main-
tained some of the authority of the usher over both
of the youths. The spirit of work was strong within
him. Soon after Simpson joined him he related that
he could then do with four hours' sleep, John Reid
with six, but he had not been able to break in James
yet. What MacArthur and the Arts course could
not do, however, the attraction of medicine accom-
plished without eflfort, and Simpson soon formed the
habit of early rising.
It seems remarkable that so much study should
have been required when, compared with to-day, the
science of the heahng art was in but a rudimentary
condition. The teachers of the day had, in spite of
Sydenham, a great regard for authority, and burdened
their students with much that is utterly unknown to
the present generation, and, if known, would be
regarded as worthless. A very large part of the
curriculum consisted of practical and bedside work, so
that book study was necessarily left to the evening or
early morning. All three students, moreover, were
fired with ambition, and thirsted for something more
than mere professional knowledge. MacArthur con-
stantly urged on his two young friends, and foretold
great things for them if only they would work.
When he afterwards heard of their successes he used
to say, " Yes, but how they worked." Simpson became
21
SIR JAMES SIMPSON
the greatest living obstetrician, and Reid rose to be
Professor of Physiology in St. Andrew's University.
MacArthur never became famous ; his name is known
only because of the initial impetus which his influence
gave to the professional careers of his two young
friends.
In his close association with two such men as
MacArthur and Reid, Simpson was again fortunate in
his environment. The art of medicine was also
fortunate inasmuch as at the right moment the right
influences were at work to direct his mind towards
it. While occupied in mastering the laws of
hexameter and iambic or in assimilating the prescribed
portion of Virgil and Tacitus, he happily now and then,
living with two such enthusiastic medical students,
got a taste of the more stimulating study of things
scientific — food which was more agreeable to his
mental palate, more suited to his mental digestion.
By peeps into anatomical books, by little demonstra-
tions of specimens in their lodgings, and by occasional
visits to some of the lecture rooms or the wards of
the Infirmary, his appetite was whetted for that
great study of nature which his youthful training at
Bathgate had prepared him for, and for which his
mental constitution was specially adapted. One can
picture the eagerness with which he would cast aside
the finished Greek or Latin essay and urge the not
unwilling embryo professor to demonstrate a bone or
lecture on an anatomical preparation.
22
STUDENT DAYS, 1825-1830
Sometimes as a special favour he was taken by Reid
to hear one of the lectures of the notorious Robert
Knox, the extra-academical teacher of anatomy, whose
strong personality and unrivalled powers as a lecturer
were at that time attracting to Surgeon's Square
hundreds of students, while Munro (Tertius) was
mechanically repeating his grandfather's lectures from
the University chair.
It was towards the end of 1828, when Simpson
was just about commencing his m.edical studies that
Edinburgh, and in fact the whole of civilised Europe,
was horrified by the revelation of the doings of Burke
and Hare, when they were at last brought to justice for
the long series of crimes perpetrated for the purpose of
selling the bodies of their victims to the anatomical
schools. Knox having a class of some four hundred
students had special difficulty in meeting the demand
for " subjects," and it was brought to light at the
trial of Burke that the majority of the bodies were
disposed of to Knox. As was only natural, a fierce
indignation against Knox sprang up in the city. His
residence was assailed and his effigy burnt. His life
was in danger at the hands of the mob on more than
one occasion.
Lord Cockburn in his " Memorials of His Time "
says that all the Edinburgh anatomists incurred an
unjust and very alarming though not an unnatural
odium — Dr. Knox in particular, against whom not
only the anger of the populace but the condemnation
23
SIR JAMES SIMPSON
of more intelligent persons was directed. " But,"
he says, " tried in reference to the invariable and the
necessary practice of the profession our anatomists
were spotlessly correct and Knox the most correct of
them all."
These were stirring times in Edinburgh medical
circles. The strong, cool demeanour of Knox under
the persecutions to which he was subjected, must have
made an indelible impression on Simpson's mind, and
the memory of it may have served to strengthen him
in later years when himself subjected to the unjust
accusations of thoughtless and ignorant people.
One night when Knox had attracted a large class
to hear him on a favourite subject, the crowd in the
street mustered in unusual force ; the yells and howls
from outside were heard distinctly in the class-room.
The students got alarmed, and kept looking to the
doors of egress. Knox perceiving the restlessness and
alarm of his audience paused, and then addressed to
them reassuring words, expressing his contempt for the
cowardly mob, and reminding them of the great
men who at different tim.es had suffered persecu-
tion for the cause of their science. His statement
was received with such cheers as resounded beyond
the class-room walls and actually cowed the
uproarious mob, so loudly did the students applaud
the words of the man who, they knew, daily placed
his life in danger in order to lecture to them, and
whose last hour seemed to have come, so great
24
STUDENT DAYS, 1825-1830
and threatening was the crowd on this particular
evening.
If Simpson did not actually witness such a scene as
the foregoing — he was not a member of Knox's class
until the session 1830-31 — he must at least have
known full well about it at the time, and shared
with the whole body of students the worship of the
man as a hero. His fellow lodger, Reid, was not only
a distinguished pupil in Knox's class, but became one
of Knox's demonstrators in 1833, ^^^ ^^^ always a
prominent Knoxite. We know also that Knox went
down to Bathgate to visit Reid's relations there, so
that it is justifiable to conclude that Simpson came
closely in contact with this remarkable teacher. That
the relationship between Reid and Simpson was most
intimate we have the former's own words for. At a
public dinner given to him when appointed to his
professorship in 1841, he said, "In the croupier
(Simpson) I recognise my earliest friend, a native of
the same village. We were rivals at school and at
college. We stood to each other from boyhood up-
wards in every possible relation, whether of an educa-
tional, warlike, delicate, or social character, which the
warm and fitful feelings peculiar to boyhood and youth
can produce."
In the end Knox and Reid quarrelled over a scien-
tific matter. Knox never recovered from the effect of
the Burke and Hare incident; in spite of the favour-
able report of an influential committee appointed to
25
SIR JAMES SIMPSON
inquire into his share in the proceedings, and his own
explicit statements, the pubh'c never acquitted him or
at least a wilful shutting of his eyes to much that
ought to have aroused his suspicions. His crowded
class-room gradually became empty during the next
few years, and the once brilliant, talented, and deter-
mined man became demoralised and left Edinburgh.
Christison says that Knox finally died almost destitute
in London, and that one of his last occupations was
that of showman to a party of travelling Ojibbeway
Indians.
However the strong personality and attractive
lecturing of Knox may have influenced him, it is
undoubted that to the personal influence of Mac-
Arthur and Reid, acting upon his constant hunger to
know nature arnd truth, stimulated as it was by what
he saw of anatomy and physiology, v/e owe the fact
that Simpson decided to enter the medical profession.
Although the number of medical students in Edin-
burgh University reached one of its highest points
during the years that Simpson was a student, it is
remarkable that with one, or perhaps two, exceptions,
the University professors were men of no marked
eminence in their various subjects. On the other
hand, the extra-mural teachers included men of such
wide reputation as Knox, Lizars, and Liston. Syme,
who reached the height of his fame as a surgeon about
the same time that Simpson became renowned, had
just resigned the teaching of anatomy to take up
26
STUDENT DAYS, 1825-1830
surgery ; shut out at first from the wards of the
Royal Infirmary by jealous colleagues, he was boldly
establishing for himself the little Minto House Hos-
pital, which became the successful nursery of his own
unsurpassed system of clinical teaching, and remains
in the recollection to this day as the principal scene
of Dr. John Brown's pathetic story, " Rab and his
Friends." It was chiefly these extra-academical
teachers who at that time made the medical school
famous, and were raising for it a reputation in surgery
such as it had acquired in physic in the days of CuUen.
In certain subjects the students would, according to
the regulations for the degree, take out their tickets
of attendance on the professor's course of lectures, but
would put in only a sufficient number of appearances
to entitle them to the necessary certificates ; the real
study of the subject being made under the more
accomplished teacher outside the University walls.
Edinburgh was at this period much more than the
scene of the foremost medical and surgical teaching of
the day in the world. It was a striking centre of in-
tellectual activity. Sir Walter Scott, Cockburn, and
Jeffrey were famous in literature and politics ;
Chalmers and Moncrieff in Church affairs ; and
Aytoun, John Wilson, Sir William Hamilton, and
Sir David Brewster were names, that attracted men
from far and wide to the modern Athens. English
and foreign advocates, scholars, artists, squires, and
noblemen mingled together to hear or see some of
27
SIR JAMES SIMPSON
these men. Lord John Russell, Henry Temple —
subsequently Lord Palmerston — and Lord Melbourne
were amongst the young Englishmen who attended
university classes for a session or two ; and H.R.H.
the Prince of Wales, and his brother the Duke of
Edinburgh, each matriculated in later days. When
Simpson began his studies Knox was the great lion,
without a visit to whose class-room no sojourn in
Edinburgh was complete ; just as in later years
Simpson's house in Queen Street was the resort of all
sorts and conditions of distinguished people.
The University had little control over her students
once they were outside the gates of the quadrangle.
There were no residential colleges ; each youth found
lodgings for himself suitable to his means, and led a
perfectly independent life. So long as he conducted
himself with propriety within her walls his Alma
Mater cared little how he conducted himself or how
he fared outside. Before 1858, when the Town
Council controlled University affairs, there were
sometimes attempts to order the comings and goings
of students. It is recorded that in 1635 the Town
Council discovered that the scholars of the College
were much withdrawn from their studies by " invita-
tions to burials," which "prejudiced their advance-
ment in learning," and they enacted that no student
was to be permitted to attend burials except those of
University or city worthies. This was at a time when
some of the students were provided with residences
28
STUDENT DAYS, 1825-1830
inside the University, but by the beginning of the
eighteenth century College residence had ceased.
From time to time attempts have been made to render
the students conspicuous in. the city by the wearing
of red gowns, but without success ; and those of all
faculties continue to be their own masters, in marked
contrast to the mode of government in force at Oxford
and Cambridge. Recently, in the eighties, a batch of
students who had figured in the police-court after a
riot in the gallery of a theatre were surprised to find
themselves summoned before the Senatus Academicus
and rusticated for varying periods ; this, however, was
but a spasmodic exercise of power. The chief advan-
tage claimed for this custom of leaving the student to
his own devices is that it encourages independence and
develops each man's individuahty better than a system
of discipline and control. In men of Simpson's calibre
it certainly has had a good eirect.
Although the family in Bathgate strained every
nerve to keep James well supplied with the neces-
sary funds as a student, they were not able to place
him in such a pecuniary position as to make it un-
necessary for him to exercise economy. He appears
to have been very careful indeed of the money which
he had ; much more careful than when he reckoned
his income by thousands. He kept methodical
accounts of his expenses down to the most trivial
items, and regularly submitted them to his family.
His cash-book opened with the following quotation
29
SIR JAMES SIMPSON
from a small book called the " Economy of Life," which
figures at a cost of ninepence : — " Let not thy recrea-
tions be expensive lest the pain of purchasing them
exceed the pleasure thou hast in their enjoyment " ;
and to this he added : —
" No trivial gain nor trivial loss despise ;
Mole-hills, if often heaped, to mountains rise.
Weigh every small expense and nothing waste ;
Farthings long saved amount to pounds at last."
It is easy to see here the imprint of a well-known
national characteristic, from which, however, he com-
pletely shook himself free when prosperity came to him.
His share of the rent of the Adam Street lodging
amounted to only three shillings a week. The entries
in the cash-book show how frugally he lived and how
every spare sum was devoted to the purchase of books.
His library, the foundation of much of his encyclo-
paedic knowledge, was a curious mixture. Adam's
"Antiquities," Milton's Poems, Byron's "Giaour" and
" Childe Harold," a Church Bible, Paley's " Natural
Theology," Fife's " Anatomy," and " The Fortunes
of Nigel," were amongst those entered as purchased.
The daily entries were such as the following : — " Sub-
ject (anatomical), £^i ; spoon, 6d. ; bread and tart,
IS. 8d. Duncan's Therapeutics, Qd. ; snuflF, ijd. ;
Early Rising, 9jd."
He followed out the usual student's custom of the
day of learning dispensing by serving for a time in a
chemist's shop. The late Dr. Keiller, of Edinburgh,
30
STUDENT DAYS, 1825-1830
used to relate how, while he himself was so employed
in a chemist's shop in Dundas Street, one day " a little
fellow with a big head " was brought in and entered
as a pupil by a relative. The little fellow was Simpson,
and no sooner was he left in the shop than he sat down
with a book upon drugs, and turning to the shelves took
down drug after drug to read up. The prompt industry
of the big-headed fellow deeply impressed Keiller.
James attended most of the University classes, but
studied surgery under the great Robert Liston, the
foremost extra-mural surgeon, daring and skilful as an
operator and of great repute as a lecturer, who after-
wards filled the post of Professor of Clinical Surgery
in University College Hospital, London. Liston was
an abrupt-mannered but sincere man, and a keen
lover of truth. He was a warm advocate of hospital
reform, and was successful in introducing several
needed improvements into the Royal Lifirmary after
a fierce fight. Here again Simpson was brought
under the influence of a strong, self-reliant man
with a distinct tendency towards controversy, to
whom he was also attracted by the fact that Liston
was a native of Linlithgowshire. Liston and Syme,
after being close colleagues, quarrelled most fiercely,
and were bitter rivals until Liston removed to London
in 1835. Simpson attended Liston's lectures during
three sessions.
There is no record of his having obtained great
distinction in any of the medical classes, but his
31
SIR JAMES SIMPSON
certificates show that he worked with pre-eminent
diligence in them all, and obtained a characteristic
mastery of each subject. If any exception occurred it
was in the very subject in which he afterwards earned
his greatest scientific fame — that of obstetrics. He
attended Professor James Hamilton's course of lectures
on that subject early in his career, and apparently felt
so little interest — the subject only became a com-
pulsory one for examination for qualification in 1830
— that he regularly went to sleep during the lecture.
The excuse urged was that the lecture being a late
one, three to four in the afternoon, it found him tired
out after a long morning of study, lectures, and
practical work. But had he been keenly interested
he would have been wide awake, for Hamilton was
a forcible, if pjain, lecturer.
Hamilton was another of Simpson's teachers who
exhibited the same uncompromising fighting character-
istics— eager and strenuous in his efforts to obtain
some object — which Simpson himself afterwards dis-
played. He fought hard for fifteen years to gain
recognition for the subject which he taught, and to
have it included in those necessary for qualification.
He succeeded in the end, but in the course of the
struggle had to bring two actions at law against pro-
fessional brethren. In one the defendant was Dr.
Gregory, whose teaching was mainly responsible for
the British system of medical practice in the early
part of this century, viz., free purging, free bleeding,
32
STUDENT DAYS, 1 825-1 830
and frequent blistering, and who was the inventor of
that well known household remedy, Gregory's powder.
Gregory was also a pugnacious man and could not
abide the pretensions of the representative of the
despised art of midwifery ; he administered a public
caning to him, and had to pay ;/^iOO in damages
which, it is said, he offered to pay over again for
another opportunity of thrashing the little obstetrician.
This encounter occurred before Simpson became a
student, but the memory of it was frequently re-
vived in the subsequent disputes which Hamilton
carried on.
The notes which Simpson took of the curriculum
lectures were concisely made and full of comments,
criticisms, and queries. He by no means bowed down
to authority ; he allowed nothing to pass which he
did not understand at the time, and specially noted
points which it seemed to him his teachers themselves
did not understand.
Like most young men of his abilities and tempera-
ment, Simpson took pleasure in rhyming, and some of
his verses are preserved. They indicate something of
the rollicking spirit of the medical student's life seventy
years ago. The medical student at that date has been
described in a recent interesting sketch of Edinburgh
student life as wearing a white great-coat and talking
loud ; his hat was inclined knowingly to one side of his
head, and the bright hues of an Oriental handkerchief
decorated his neck. There was a great deal of acting in
33 ^
SIR JAMES SIMPSON
his motions. He was first at the door of the theatre on a
Saturday night, and regardless of the damages sustained
by the skirts of his coat, secured the very middle seat
of the fifth row of benches in the pit. Simpson, how-
ever, hardly conformed to this description. He
enjoyed recreation as much as any man, and had a
keen sense of humour which made him popular among
his fellow students, but he was saturated with the love
of study and was not led into extravagances of the
Bob Sawyer type, or the harmless inanities of Albert
Smith's immortal Medical Student.
During the long summer vacation he noted care-
fully his observations on the botany, zoology, geology,
and even the meteorology of the Bathgate district.
Dr. Duns, in his memoir, points out that he was much
more at home with the phenomena of organic than
with those of inorganic forms. His highest powers
came into play when he had to do with the presence
of life and its varied manifestations. Even his anti-
quarian notes illustrated this. He passed at once from
the things to the thoughts and feelings of the men
associated with them.
In the holidays he also assisted the village doctor
in visiting and dispensing, and lent a willing hand
in his father's shop when he was wanted, often enough
driving the baker's cart on the daily round of bread
delivery.
In January of the year 1830 his father was taken
seriously ill, and James hastily left Edinburgh and
34
STUDENT DAYS, 1825-1830
tended him till his death. On his return he presented
himself for the final examination at the College of
Surgeons. This he passed with ease and credit in
April, and found himself a fully qualified medical
practitioner at the age of eighteen.
35
CHAPTER III
Further Studies, i 830-1 835
Applies for a village appointment — Disappointment — Brother's help to
further studies — Dispensary assistant — Obtains University M.D.,
1832 — Thesis — Assistant to the Professor of Pathology — Turns to
obstetrics — Attends Professor Hamilton's lectures again — Royal
Medical and Royal Physical Societies — Edward Forbes — The
Oineromathic Society — Foreign tour — Visits Liverpool and meets
Miss Jessie Grindlay — His characteristics, principles, and m.ethods,
with extracts from addresses.
THERE now came the first crisis in Simpson's
medical career. After his father's death he felt
that having obtained his qualification to practise it was
his duty to relieve his family of the burden of support-
ing him through more extended studies. After due
deliberation he applied for a small appointment which
would have served as a nucleus for private practice,
that of parish surgeon to a small village on the banks
of the Clyde. Those in whose hands the appoint-
ment lay were not impressed with his fitness for the
post, and he was not elected. " I felt," he afterwards
said, " a deeper amount of chagrin and disappoint-
36
FURTHER STUDIES, 1830-1835
ment than I have ever experienced since that date. If
chosen, I would probably have been working there as
a village doctor still." Although such a commence-
ment might have delayed his ultimate rise to eminence,
it cannot be agreed that it could possibly have prevented
it. It was at this crisis that what he tenderly referred
to as " the ceaseless love and kindness of a dear elder
brother " came to his rescue, and by Alexander's or,
as he affectionately called him, " Sandy's " help, he
returned to Edinburo;h to resume his studies in the
winter session, 1830-31. His other brother, David,
had started in business as a baker at Stockbridge, close
to Edinburgh, and James boarded with him there for
a time. His qualification enabled him to become
assistant to a Dr. Gairdner in dispensary practice, a
class of work he had had some experience of in the
previous year while staying with Dr. Girdwood at
Falkirk during the summer. Dr. Gairdner was much
struck with Simpson's abilities, which he stated,
" promised the most flattering expectations." In the
course of his first experiences of actual practice he
became impressed with the necessity for a knov/ledge
of obstetrics, and therefore attended lectures on the
subject by Dr. Thatcher, an extra-mural teacher of
repute, who subsequently applied for the University
chair of midwifery when Simpson was the successful
candidate.
His chief object, however, was to qualify for the
degree of Doctor of Medicine of the University, and
37
SIR JAMES SIMPSON
this he succeeded in doing in 1832. The regulations
for this coveted degree were, for the times, wonderfully
complete ; it was held in such high estimation and
such large numbers qualified annually — in 1827 there
were one hundred and sixty graduates — that the
authorities felt justified in being stringent. The
length of the course of study necessary for gradua-
tion had been fixed at four years, and required the
candidate to have attended classes in Anatomy,
Surgery, Materia Medica, and Pharmacy, the
Theory and Practice of Medicine, Clinical Medicine,
Midwifery, Chemistry, and Botany, as well as a three
months' course in any two of the following : —
Practical Anatomy, Natural History, Medical Juris-
prudence, Clinical Surgery, and Military Surgery.
The first step iii examination took place at the house
of one of the professors where the candidate v/as
questioned in literary subjects, chiefly Latin, and in
the different branches of Medicine and Surgery. If
he passed this satisfactorily he was examined more
mJnutely by tvv^o professors in the presence of the
others, and w^as subsequently given two Aphorisms of
Hippocrates to explain and illustrate in writing and to
defend before the faculty, as well as two cases with
questions attached. The last step was the presenting
of a thesis which was read by one of the faculty and
was publicly defended by the candidate on the day of
graduation. All this examination was conducted in
Latin. Simpson's thesis was entitled : " De causa
38
FURTHER STUDIES, 1830-1835
mortis in quibusda?n inflammatioyiibus proximal He
was amongst the last graduates who were examined
through the medium of Latin, for after 1833 the
language was optional, and English soon became the
only one used ; at the same time the examinations
were differently arranged, and made to consist of more
thorough and prolonged written and oral stages.
Being on a pathological subject, Simpson's thesis was
allotted to Thomson, the professor of Pathology,
to examine, who not only recommended the author
for the degree, but was so impressed by the ability
displayed in the dissertation that he sought him out
and promptly offered him the post of assistant, which
Simpson as promptly accepted. This appointment
was most welcome. Not only did it give him a
much desired opportunity for pathological work, but
the salary of ^50 a year enabled him to free his family
from the immediate necessity of supporting him.
If to MacArthur and John Reid was due the credit
of first directing Simpson's thoughts to the study of
medicine, to Professor John Thomson belongs the
credit of having made him an obstetrician. " At
Dr. Thomson's earnest suggestion and advice," says
Simpson, " I first turned more especially to the study
of midwifery with the view of becoming a teacher of
this department of medical science." He lost no time
in throwing himself heartily into the work that was
nearest to him, and became almost indispensable
to his chief. Most of his time was spent in the
39
SIR JAMES SIMPSON
Pathological Museum, busily engaged in arranging,
classifying, and describing the preparations, but he also
assisted in preparing the professor's lectures. He took
up more readily than Thomson the then new mode
of study by the microscope, and it is related that once
he composed a lecture for his chief on this subject
which Thomson delivered without previous perusal.
Several times as Thompson read the lecture to the class
he looked up to glare at his assistant, and when they
returned to the side room he shook his fist in his face,
saying, " I don't believe one d — d word of it."
Although Simpson was now earning enough by his
salary as assistant to meet his expenses at the time, his
family maintained their loving interest in his welfare.
His sister told him he was working too hard and
hurting his health. " Well," he replied, " I am sure
it is just to please you all."
Sandy, who had married in 1832, watched his
career carefully, and when the cholera made its
appearance in Scotland he made a will with a pro-
vision for " my dear James " iji the event of his death.
"I daresay," he addressed his family therein, "every
one of you has a pleasure in doing him good by
stealth as I have had myself."
By Thomson's advice Simpson attended Hamilton's
lectures in the winter session 1833-4, and this time
with awakened interest. With the definite object
of devoting himself to Midwifery clearly in view
Simpson worked with all his phenomenal energy
40
FURTHER STUDIES, 1830-1835
during the years from 1832 to 1835, studying the
subject while he was helping Thomson. He entered
the front rank of the young graduates of his day, and
was elected a member of the Royal Medical and
Royal Physical Societies in the same year, 1833. Both
these societies were for the encouragement of scien-
tific study and discussion among students and young
graduates, and to obtain the Presidential chair of either
was a high honour. The Royal Medical Society was
the oldest Society in the University, having been estab-
li'ohed in 1737 by the great CuUen and others ; it had
always been of great account in the University, and
the originality of the utterances on professional matters
which emanated from it made it then a power to be
reckoned vv^ith not only in Edinburgh, but throughout
European professional circles. For membership of
the Royal Physical Society he was proposed by
Edward Forbes, a brilliant youth, who subsequently
distinguished himself in Natural History, and held
the University Chair in that subject for a brief period
until cut down prematurely at the age of thirty-nine.
Forbes was the leader of a set of able young students
who have left a distinct mark in the history of the
University. John Reid was an intimate friend of
Forbes, and Simpson was probably as intimate with
him. Forbes was the founder and editor of the best
of all the shortlived literary ventures of Edinburgh
undergraduates — The University Maga^ which was
issued weekly in 1834 ; and he was also one of the
41
SIR JAMES SIMPSON
founders of the Oineromathic Society, " The brother-
hood of the friends of Truth." Forbes thus described
the nature of this Society in song : —
"Some love to stray through lands far away,
Some love to roam on the sea,
But an antique cell an 1 a college bell,
And a student's life for me.
For palace or cot, for mead or grot
I never would care or pine.
But spend my days in twining lays
To Learning, Love, and Wine."
" Wine, Love, and Learning " was the motto of this
curious brotherhood, and it numbered in its member-
ship many men of the day, who afterwards became
eminent, such as Forbes himself, Reid, George Wilson,
Goodsir, and Bennet. Simpson must have been quite
cognisant of this Society's doings ; he was closely
associated with its leaders, but his name does not
appear in any of the lists of members still preserved.
His whole-hearted devotion to the MA9HSIS pro-
bably prevented his uniting with the brotherhood to
worship the EPOS and OINOS. The brotherhood
was conspicuously united. In the great snowball
riot of 1837, which was quelled only by the reading
of the Riot Act and the marching down at the double
from the Castle of the Cameron Highlanders into
the University gates, they fought shoulder to shoulder.
In 1835 Simpson felt that the time had come to
enter into serious practice and turn his acquired know-
ledge to account. Fifty pounds a year was no large
42
FURTHER STUDIES, 1830-1835
income on which to satisfy his craving for learning,
and there was no surplus from which by any means
to repay his family for their assistance. Before taking
any decided step, however, he desired to pay a visit to
the Continental centres of medical science and teaching.
The funds for the proposed tour were promptly found
by his brothers Alexander and John ; by their assistance
he was enabled to visit Paris, Liege, and Brussels, as
well as London and Oxford. He was accompanied by
Dr. (now Sir Douglas) Maclagan, and kept a journal
of the tour, which is an interesting example of his
lively powers of observation. In London he visited
the leading hospitals, and made the acquaintance of
the leading physicians and surgeons, amongst whom
were many alumni of his own alma mater. In the
journal he freely and concisely criticised the men,
their methods, and their hospitals. In Paris he
followed the same plan, going the round of all the
hospitals, and searching for and grasping the prin-
ciple which guided each distinguished man's thought
and teaching. He took more than a medical interest
in all that he saw, and noted the appearance and
habits of the people of each place that he visited.
At the end of his coach ride from London to South-
ampton, on the way to Paris, he sat down to write : —
" The ride as far as Windsor Park was delightful, and
from the top of the coach we had two or three most
lovely glimpses of EngHsh scenery. After passing
Windsor the soil was rather inferior in many parts,
43
SIR TAMES SIMPSON
and we passed every now and then large tracts of
heath. . . . The neatness and cleanliness of the
English cottages is greatly superior to all that we
have in Scotland ; the little patches of garden ground
before, behind, and around them set them off
amazingly. I wish the Scottish peasantry could by
some means or other be excited to a little more
love of cleanliness and horticulture. I did not see
above two or three dirty windows, men or women
along the whole line of road. The snow-white
smock-frocks of the Hampshire peasantry do actually
look well in my opinion."
At Liege on June 13th he wrote: — "And is it
possible that I here begin a second volume of a
journal ? . . . I began my journal chiefly with some
distant prospect of teaching myself the important
lesson of daily notation. I am vain enough to flatter
myself nov/ that I have partly at least succeeded. At
all events that which was at first a sort of task, at
times rather an annoying task, has now become to me
a pleasure. If I had my first volume to write over
again I think I would now write it twenty times
better. In writing a journal 'tis needless to think
of making no blundei-s in the way of blots and bad
grammar or of crooked sentences. We, or at least I,
have occasionally felt so confoundedly tired at night
that if I had been obliged to attend to such minutiae
I certainly would not have been able to advance above
two sentences.
44
FURTHER STUDIES 1830-1835
" This morning rose by half-past seven — dressed
and breakfasted on coffee and rolls, read the Liege
Courier^ and by nine o'clock called on Professor
Fohman with a copy of Dr. Reid's paper on the
glands of the whale, which I had promised him yester-
day. The Professor kept us until five minutes to ten,
lecturing us on his discoveries upon the original
elementary tubular structure of animal tissues. Some-
body has remarked that no person ever entered into or
at least came out of the study of the Book of Revela-
tion without being either mad before or mad after it.
I would not choose to say that Dr. F.'s case is perfectly
analogous, but has it not some analogy r He seems to
run wild on elementary tubular texture ; .... he
hates Lippi and his researches with a perfect hatred.
Lippi has been preferred to him by the Parisian
Academy. Is he not working against Lippi, and it
may be against truth, if they happen to go together,
which I do not believe ?
" We have taken our seats in the diligence to-
morrow for Louvain, and on leaving Liege I must
confess that I leave one of the most lovely places
I have seen on the Continent. 'Tis rich, populous,
busy ; the town in itself is old and good, though not
so neat and clean as Mons ; its environs wild and
romantic. Besides it seems full of good-natured gash
old wives, and sonsy, laughing-faced, good-looking,
nay, some of them very good-looking girls."
The homeward journey was made via Birmingham,
45
SIR JAMES SIMPSON
Liverpool, and Glasgow. In Liverpool he called upon
a distant relative named Grindlay, established there as
a shipper, and laid the foundation of a life-long
friendship w^ith the family. He also then for the
first time met Miss Jessie Grindlay who afterwards
became his wife.
With the end of this tour, Simpson brought to
a close the more strictly student part of his career,
although it remained true of him, as of all eminent
scientific men, that he was a student to the end of his
days. He felt himself now fully equipped to enter
into the professional battle, and he stepped into the
arena, not only full of vigorous life and hope, but
possessed of highly trained faculties, keen senses, and
lofty ideals. It was his strong, personal characteristics,
apart from his accomplishments, which at once placed
him head and shoulders above his fellows. " He had
a great heart," says a recent writer, " and a marvellous
personal influence, calling forth, not only the sympathy
and love of his fellowmen, but capable of kindling
enthusiasm in others almost at first sight." It is
impossible to overestimate this personal influence in
analysing the elements of his ultimate success, and it
is more impossible for those who did not feel it to
realise its nature ; but that he became the beloved
as well as the trusted physician is due to this influence.
" He had no acquaintances," says the writer already
quoted ; " none could come into contact with him and
stop short of friendship." This was a powerful trait to
46
FURTHER STUDIES, 1830-1835
possess ; it cannot be denied that he was fully aware
of it and its value ; and used it with good eflPect in
establishing himself as the greatest physician of his
day.
As a scientist he started with an eager desire for
knowledge and reverence for truth, to which was
added the highly developed power of mental concentra-
tion born of early self-training. When most men
would be waiting in what they would term enforced
idleness, Simpson would be busy with book or pen,
deeply attentive to his occupation despite surrounding
distractions or temptations to frivolous idleness. He
took the full measure of the value of Time and handled
his moments as another would a precious metal. " At
all times," he said himself, "on all occasions, and
amidst the numerous disturbing influences to which
the medical man is so constantly subjected, he should
be able to control and command his undivided mental
attention to the case or object that he may have
before him. ... In the power of concentrating and
keeping concentrated all the energies of attention and
thought upon any given subject, consists the power
of thinking strongly and successfully upon that sub-
ject. The possession or the want of this quality of
the mind constitutes the main distinction between the
possession or the want of what the world designates
' mental abilities and talents.' "
His high ideals, his conception of the functions of
the physician, and the strivings of the scientist are
47
SIR JAMES SIMPSON
best shown in his own words: — "Other pursuits
become insignificant in their objects when placed in
contrast with ours. The agriculturist bestows all his
professional care and study on the rearing of crops and
cattle ; the merchant spends his energies and attention
on his goods and his commissions ; the engineer upon
his iron-wheels and rails ; the sailor upon his ships and
freights ; the banker upon his bills and his bonds ; and
the manufacturer upon his spindles and their products.
But what after all are machinery and merchandise,
shares and stocks, consols and prices-current, or the
rates of cargoes and cattle, of corns and cottons, in
comparison with the inestimable value and importance
of the very lives of these fellowmen who everywhere
move and breath and speak and act around us ? What
are any, or- what are all these objects when contrasted
with the most precious and valued gift of God —
human life ? And what would not the greatest and
most successful followers of such varied callings give
out of their own professional stores for the restoration
of health and for the prolongation of life — if the first
were once lost to them, or if the other were merely
menaced by the dreaded and blighting finger of
disease ? "
In one of his addresses of later years he urged upon
his students the objects and motives which had been
his in early professional life : — " The objects and
powers of your art are alike great and elevated," he
said. " Your aim is as far as possible to alleviate
48
FURTHER STUDIES, 1830-1835
human suffering and lengthen out human existence.
Your ambition is to gladden as v/ell as to prolong the
course of human life by warding off disease as the
greatest of mortal evils ; and restoring health, and
even at times reason itself, as the greatest of mortal
blessings. ... If you follow these, the noble objects
of your profession, in a proper spirit of love and kind-
ness to your race, the pure light of benevolence will
shed around the path of your toils and labours the
brightness and beauty that will ever cheer you onwards
and keep your steps from being weary in well-
doing ; . . . while if you practise the art that you
profess with a cold-hearted view to its results, merely
as a matter of lucre and trade, your course will be as
dark and miserable as that low and grovelling love
that dictates it."
Simpson's method of study was simple, at the
same time that it involved immense labour. In
entering upon a new work his first proceeding was to
ascertain conscientiously all that had already been said
or written by others upon the subject. He traced
knowledge from its earliest sources and was able, as he
followed the mental workings of those who had
preceded him, to estimate the value of every vaunted
addition to the sum of knowledge ; and to weigh the
theories and new opinions of men which had been
evolved with the progress of time, and which had
sometimes obscured, instead of casting greater light
upon the truth. His antiquarian tastes added to his
49 ""
SIR JAMES SIMPSON
knowledge of Latin helped him in this work and
turned a tedious task into a real pleasure. This
prehminary accomplished, he plunged into the work
of adding to the knowledge of the subject by thought,
research, experiment, or invention.
In writing upon an abstract subject he would dis-
entangle the confused thoughts of his predecessors and
restate their opinions in direct and sim.plified language.
But matters of opinion never had such an attraction
for him as matters of fact ; in dealing with these latter
he would test by experiment the statements of
authorities and correct or add to them by his own
researches. Most of his professional writings, as well
as his archaeological works, are valuable for the
historical resume of the knowledge on the subject
as well as for his additions. His later writings show
as careful an attention to the inductive method with
which he started, as those produced in the days of his
more youthful enthusiasm ; when fame was attained
and fortune secured, when excessive work was sapping
his physical strength, he never sank into lazy or
slovenly methods in scientific work, but ever threw
his whole vigour into the self-imposed task.
When studying Nature directly he was constantly
asking her "why?" — ^just as in his notes of his
teacher's lectures the query was ever recurring. He
never felt .himself beaten by an initial failure, but
returned again and again with his questions with
renewed energy each time. He was not to be denied,
50
FURTHER STUDIES, 1830-1835
and in this manner he wrested from Nature some of
those precious secrets the knowledge of which has
relieved suffering and prolonged human life in every
corner of the globe. " He never kept anything
secret," says his nephew and successor, Professor
A. R. Simpson, " that he thought could help his
fellows, and it is hard to say whether his delight was
greater in finding some new means to cure disease, or
in demonstrating to others his methods of treatment."
He was indeed clothed in well-nigh impenetrable
armour, and pro\'ided with powerful weapons, when
in the autumn of 1835 he returned from his foreign
tour to commence the serious fight in which his
avowed object was not only to obtain professional
eminence, but to stand forth a proud benefactor of the
human race. Although he appealed always directly
to Nature and used his own well-trained eyes and ears
in preference to those of others, he did not completely
brush aside authority as Sydenham had done ; he
hesitated neither to extract all that was valuable, nor
to discard what appeared worthless from the writings
of past masters.
51
CHAPTER IV
Early Practice and Professorship, i 835-1 840
President of Royal Medical Society — Personal appearance — Practice
among the poor — Corresponds with Miss Grindlay — Lecturer on
obstetrics — Resignation of Professor Hamilton — Applies for vacancy
— Active candidature — Strong opposition — Marriage — Account of
the midwifery Chair — The medical professors at the time —
Their opposition — Cost of candidature — Triumphant election.
IN November, 1835, Simpson was elected one of
the annual Presidents of the Royal Medical
Society ; a position which has been occupied by many
young Edinburgh graduates, who have subsequently
risen to fame. He took pains to make his inaugural
address worthy of the occasion, and chose a subject con-
nected with the pathology of obstetrics. It was a great
success, and contributed largely towards giving him a 1
recognised position as an authority in that branch of
study. After appearing in the Edinburgh Medical and
Surgical Journal ^or January, 1836, it was translated
into French, Italian, and German. It also obtained
for him his first foreign honour — one of a long list that
52
EARLY PRACTICE, 1835-1840
was made up through his lifetime — that of correspond-
ing member of the Ghent Medical Society ; indeed,
his early works received more attention and apprecia-
tion abroad than at home. In 1836, in order to widen
his experience in his chosen subject, he filled the post
of house-surgeon to the Lying-in Hospital, and held
it for twelve months. He was also elected a Fellow of
the Edinburgh College of Physicians. From this time
he became a profuse writer on professional subjects,
and developed an easy and convincing style ; he
carried on this work pari passu with practice amongst
the poorer classes of the city and in addition to his
work in connection with the Pathology Chair, always
keeping in view his great object of becoming an ob-
stetrician. It was not until 1838 that he became an
independent lecturer on Midwifery. He had intended
to do so earlier, but owing to Professor Thomson's
ill-health, he had been called upon to act as Deputy-
Professor of Pathology, a most valuable and useful
employment.
Simpson's personal appearance at this time has been
described by one who visited a meeting of the Royal
Medical Society on an evening when he was in the
chair : — " The chair was occupied," says the narrator,
" by a young man whose appearance was striking and
peculiar. As we entered the room his head was bent
down, and little was seen but a mass of long tangled
hair, partially concealing what appeared to be a head
of very large size. He raised his head, and his coun-
53
SIR JAMES SIMPSON
tenance at once impressed us. A pale, rather flattish
face, massive brent brows, from under which shone
eyes now piercing as it were to your inmost soul, now
melting into almost feminine tenderness ; a coarsish
nose with dilated nostrils, finely chiselled mouth which
seemed the most expressive feature of the face. . . .
Then his peculiar rounded soft body and limbs, as if he
had retained the infantine form in adolescence, pre-
sented a tout ense?nhle^ which even if we had never seen it
again would have remained indelibly impressed on our
memory."
In Simpson's youth physicians and surgeons made a
habit of cultivating peculiarities of appearances and
behaviour, but he v/as so shaped by nature as to attract
attention without artificial aid. The growth of long
hair seemed a, natural accompaniment to his massive
head and broad expressive countenance.
His practice at this time was scattered over the city,
and he took long tramps in the course of the day. In
one of his letters to his brothers, who were still loyally
supporting him in his increasingly successful en-
deavours to establish himself after his heart's desire,
he says : — "The patients are mostly poor it is true,
but still they are patients ; ... if my health is spared
me, I do hope I may get into practice sufficient to
keep me respectable after the lapse of years ; but I
know years must pass before that. At present I enjoy
the best possible spirits and health, and with all my
toils was never happier or healthier."
54
EARLY PRACTICE, 1835-1840
Tout vient a point a qui sait attendre. Simpson
kiiew how to wait ; lie knew tliat waiting did not
mean inactivity. Every opportunity that arose for
advancement found him prepared to take full ad-
vajitage of it.
That his lectures on pathology were acceptable
was made manifest by the address presented to him by
the students of the class at the end of his temporary
term of office, testifying to his zeal, fidelity, and
success, their admiration of his high talents, of the
varied and extensive research which he displayed, and
of his uniform and kind affability which, while it
exalted him in the eyes of all as a teacher, endeared
him to each as a friend.
During this period he kept up a correspondence
with the Miss Grindlay, of Liverpool, whose appear-
ance he had been struck with when he visited the
family, and towards the end of 1837 he found
time to visit there again accompanied by Dr. John
Reid.
The way for his appearance as an extra-academical
lecturer on midwifery was made clear at the end of
1837 by the death of Dr. Macintosh, a successful
teacher of that subject. He had been in negotiation,
without success, with this Dr. Macintosh for the
taking over of the part or whole of his lectures, and
found it easy to step at once into his place at his death.
He was firmly determined to succeed ultimately to
the University Chair of Midwifery. On one occasion
55
SIR JAMES SIMPSON
he pointed out to some fiiejids the then holder of the
Chair, Professor Hamilton, thus : — " Do you see that
old gentleman r Well, that's my gown ! "
The good luck which had been Lis during his boy-
hood did not desert him when he began his course of
lectures ; for not only did he speedily attain a reputa-
tion for teaching, science, and practical skill, wonderful
for ojie so young, but he had not two years to wait
after thus establishing himself before the chair of his
ambition fell vacant owing to the resignation in 1839
of Professor Hamilton, who died soon afterwards at the
age of seventy-two.
It was a bold step for so young a man — for Simpson
was only twenty-eight — to apply for the professorship.
He was, however, not without his precedent. The
second Monro obtained the Anatomy Chair at twenty-
five, Alison filled that of Physic at thirty, and Thomas
Hope and Alexander Christison were Professors of
Chemistry and Medical Jurisprudence respectively
each at the age of twenty-four. But this subject was
one which was popularly thought to require a man of
experience and especially a married man. Simpson
had devoted his energies but partially to midwifery
for only four or five years, and except for his
short hospital appointment and recent experience as
a lecturer on the subject had in the eyes of many
no greater claim to the post than any other general
practitioner, except in the fact that he had obtained
a wide reputation in the science of the subject by his
56
EARLY PRACTICE, 1835-1840
contribution to its literature and his researches. This
last was the point on which he himself most relied ;
for his age he had done more scientifically than any of
his opponents. Those who had watched his career
knew that he possessed in addition to zeal and ability,
brilHant teaching and practical powers. The objection
of his youth was less easily got over than that of his
unmarried state. With characteristic promptness, as
soon as he had determined to apply for the Chair and
found that as a bachelor his chances would be small,
he disappeared for a time from Edinburgh, and re-
turned triumphantly with Miss Jessie Grindlay, of
Liverpool, as his wife. It was a bold stroke which
delighted his supporters, discomfited his opponents,
who saw therein the removal of a barrier to his
success and a weapon from their hands, and astonished
the worthy town councillors in whose gift the
appointment lay.
The Edinburgh Chair of Midv/ifery was established
in 1726, and was indisputably the first Chair of its
kind in the British Islands, and probably in the world.
It was in that year that the Town Council first
established the medical faculty, by appointing two
Professors of the Theory and Practice of Medicine
and two of Medicine and Chemistry. A Chair of
Anatomy had been instituted six years earlier through
the instrumentality of the first Monro who became
its first occupant. These five chairs were considered
sufticient wherewith to teach all the medical know-
S7
SIR JAMES SIMPSON
ledge of the day, and although appointed ad v'ltam aut
culpam the professors received no remuneration out of
the city revenues. The Chair was not reckoned at
first as a faculty Chair, but was termed a city pro-
fessorship. The newly created medical faculty would
have no midwifery within the precincts of the Uni-
versity ; and this is scarcely surprising when we
remember that at iirst the only persons lectured to by
the city professor were women of an inferior class in
whose hands the practice of the art almost entirely
lay.
Along with this appointment the Town Council
established a system of regulation for midv/ifery
practice within the city. It ordered that all midwives
already in practice should at once be registered, and
that no persons should thereafter enter on the practice
within the city until they had presented to the
magistrate a certificate under the hands of at least
one doctor and one surgeon who were at the same
time members of the College of Physicians or of the
Incorporation of Chirurgeons, bearing that they had so
much of the knowledge and principles of this art as
warranted their entering on the practice of it ; where-
upon a licence should be given them signed by four
magistrates at least entitling them to practise. It was
further enacted that certain pains and penalties v/ere
to be inflicted upon ignorant persons for practising
without this licence whereby their "want of skill
might be of such dangerous consequences to the lives
5«
EARLY PRACTICE, 1835-1840
of so many people." It is to be presumed that as
qualified medical men granted them these certificates
and that these women had extensive practices, they
possessed also a fair amount of skill. But slowly and
gradually they had to give way and retire to the rank
of nurses before the rise and growing public tolerance
of the qualified male practitioner of obstetrics.
The second occupant of the chair, appointed in
1739, was elevated to a place in the medical faculty,
but Professor Thomas Young, who occupied it in
1756, was the first to teach the subject to medical
students by means of lectures and clinical instruction.
As already noted, it was left for James Hamilton
to obtain the recognition of midwifery as a subject,
a knowledge of which was necessary for the obtaining
of the University medical degree.
At the time when Simpson was straining every
nerve to gain the post he coveted, the medical faculty
of the University comprised the following professors of
the following subjects : — Botany, Robert Graham,
who established the Edinburgh and Glasgow Botanical
Gardens ; Anatomy, Monro the third j Chemistry,
Hope, who discovered strontium in the lead mines
of Argyleshire 5 Institutes of Medicine, Alison, an
eminent physician and philanthropist who first pointed
out the connection between destitution and epidemics
of disease, and secured improved Poor Laws for his
country ; Practice of Physic, James Home ; Materia
Medica, Christison, the world-reputed toxicologist ;
59
SIR JAMES SIMPSON
Natural History, Robert Jameson ; Clinical Surgery,
James Syme, the wonderful operator and teacher, and
inventor of the " macintosh " waterproof ; Military
Surgery, Ballingali ; Medical Jurisprudence, Traill ;
Pathology, Thomson ; and Surgery, Charles Bell, the
discoverer of the double function of the nerves, who
was ranked in his day on the Continent as greater
than Harvey. It was thus not an undistinguished
body that Simpson strove to enter ; several of the best-
known members were comparatively young men,
recently appointed to their posts, and full of the rising
scientific spirit. It is little to their credit that they were
practically unanimous in opposing the candidature of
this young and enthusiastic scientist, who afterwards
shed such lustre on the University from the chair
which they would have denied him for no reasons
other than his youth and his humble origin.
Fortunately for Simpson and for the University,
the appointment did not lie in the gift of the
professors, but was entirely in the hands of the
Town Council, comprising thirty-three citizens.
Such an election was always a matter of keen
interest to the inhabitants of Edinburgh, and each
candidate brought all the direct and indirect influence
within his power to bear on every councillor whom he
could reach. The Professors in the various faculties
had no doubt great influence ; they openly canvassed
for the candidate they favoured, and did not hesitate
to decry those they did not approve of. Shortsighted
60
EARLY PRACTICE, 1835-1840
as this professorial opposition was, it proved no small
difficulty in Simpson's v/ay. Foremost amongst his
opponents was Syme, who commenced a long feud
with him by supporting his chief rival, Dr. Kennedy ;
" I feel no hesitation in stating," he wrote purposely
for publication, " that of all the candidates in the field,
he (Kennedy) is out of all question, according to my
judgment, the one that ought to be elected." Sir
Charles Bell was equally emphatic, and characterised
Simpson's testimonials, in a note which Kennedy
circulated, as given by " good-natured people merely
to do a civil thing to a friend " — which was his mode
of describing the declarations of some of the most
eminent men of the day.
Each candidate also brought political influence to
bear, and Whig and Tory grew agitated as the contest
became keener. Simpson seems to have thought that
both political parties were in opposition to him, but
he certainly had the strong support of Ritchie of
Scotsman fame, and the no less important influence of
Mr. Duncan Maclaren.
When writing to ask Mr. Grindlay for his
daughter's hand, Simpson candidly confessed his
pecuniary position at the time. He referred to a
debt of ;r200 already owing to his brother Sandy,
and added : — " Again he gave me a bill for ;^I20
to assist me in furnishing my house. This has been
renewed and becomes due in January. He hopes to
be able to pay it, and I fondly imagined I would have
61
SIR JAMES SIMPSON
paid the half, but this canvass has involved me in new^
difficulties, and besides, I have endeavoured to assist my
sister to go out to Van Diemen's Land. As it is now
I am self-sufficient enough to think that I am as well off
as regards station in my profession as any who started
here in the race of life with me. They have all, I
believe, been aided by friends or by private wealth.
They have almost all been fortunate enough to have
the protection of a father's roof during the iirst years
of practice. I have had no such advantages, but have
worked and stood alone. I have accumulated for
myself a library and museum, worth /200 at least,
amidst these difficulties. These I have won by my
pen and my lancet, and these are m.y only fortune.
And now could you trust her future happiness to me
under such circumstances ? I did not intend to ask
her hand at present. I fondly hoped I might have
first cleared myself of my debts."
Grindlay did not hesitate, but willingly gave his
daughter, as she was willingly given, for better or
worse.
The expenses of the canvass amounted to about
^500, an amazingly large sum ; he spared no
expense in printing and posting his testimonials and
letters to every one who had any influence with the
Council, however sm.all ; but taking into consideration
the cost of printing and postage in 1839, it is difficult
to realise how the money was expended. His aim
was to make known his scientific attainments, powers
62
EARLY PRACTICE, 1 835-1840
as a teacher, and personal qualifications which he felt,
if duly realised, would outweigh the disadvantages
of his youth and comparative inexperience. His
testimonials spoke in strong terms of his abilities and
characteristics ; they were a good deal more numerous
and elaborate than is customary to-day, but Kennedy's
also made a fat volume of 150 octavo pages.
As the day of election drew near the excite-
ment amongst citizens, professors, and students grew
intense. Of the five candidates in the field, three,
including his former teacher Thatcher, speedily fell out
of the running. Dr. E^'ory Kennedy, of Dublin, and
Simpson stood face to face as rivals. Kennedy was no
mean opponent, and his supporters honestly considered
him the better man of the two ; his attainments
certainly merited warm support. The prophets fore-
told a close struggle, and the event proved them
correct. So keen was public interest that w^hen a
report was circulated that Kennedy was a bad lecturer,
his friends brought him over from Dublin a few days
before the election, hired a public room, and made
him lecture to a crowded and enthusiastic audience to
dispel that illusion. In spite of this the popular vote
was decidedly in Simpson's favour ; if the citizens had
had votes Simpson would have been returned at the
head of the poll by a large majority.
On Tuesday, February 4, 1840, at a Council
meeting, at which all thirty-three members were
present, the Provost himself proposed Kennedy,
63
SIR JAMES SIMPSON
while Baillie Ramsay proposed Simpson. The
result was awaited with breathless suspense, the
chamber being crowded by anxious spectators.
Simpson's enthusiasm had infected his supporters ;
he had kindled the first sparks of that enthusiastic
affection with which the citizens of Edinburgh ever
after regarded him ; when his triumph, by the
narrowest majority, was announced, the cheers re-
sounded loud and long.
The same evening he was able to write to
Liverpool : —
" I, Dean Terrace.
" I was this day elected Professor. My opponent
had sixteen and I had seventeen votes. All the
political influence of both the leading Whigs and
Tories here was employed against me ; but never
mind, I have got the chair in despite of them, Professors
and all. Jessie's honeymoon and mine is to com-
mence to-morrow\"
It was the man's strong individuality which carried
the day. The town councillors threw aside the
political and academic bias of those who endeavoured
to lead them, and elected the man who had boldly said,
" Did I not feel I am the best man for the Chair I
would not go in for it " ; and had more boldly gone
on showing them how thoroughly he felt what he
said until they themselves came to believe it.
64
EARLY PRACTICE, 1835-1840
The gift of this Chair, as of many others in the
University, has now passed from the hands of the
Town Council into those of a body of curators, seven
in number, three nominated by the University Court
and four by the Town Council ; such a body might
have made a more cautious choice, but never a more
fortunate one both for the city and the University
than this of their long-headed and far-sighted pre-
decessors.
65
CHAPTER V
Professor and Physician, i 840-1 847
Success as a lecturer — Increased practice — Generosity — Fashionable
patients — Memoir on Leprosy — Controversy concerning the Patho-
logy Chair — Address to the Graduates, 1842 — Squabbles — Pur-
chases 52, Queen Street — A great and good physician — Called to
London — Visit to Erskine House — The daily scene at 52, Queen
Street — Rangoon petroleum and Christison — The disruption — His
family — Appointed Physician-Accoucheur to the Queen for Scotland.
SIMPSON had not long been engaged upon his
new duties before the town councillors gladly
saw, and his brother professors were obliged to admit,
that the baker's son was bringing a mighty genius
to bear upon the subject of his choice from the chair
of his ambition. He cherished no ill-feeling against
those confreres who had actively opposed his candida-
ture, but set to work amidst his new surroundings
conscious that the best way to obliterate bitter feelings
was by gradually creating a stronger feeling — that of
respect for him as a man and a worker. He had dealt
heavy blows himself during the conflict — blows not
easily forgotten. The position demanded tact and
66
PROFESSOR AND PHYSICIAN
patience, and he was not found wanting in either.
He converted many who had worked against him
into adherents, admirers, and even friends.
His lectures speedily attracted students. Besides
those who were entering the profession, grey-headed
and grey-bearded men, whose student days had long
since passed away, came to sit at the feet of this
remarkable young man and hear the so recently despised
subject dealt with in his own masterly, scientific
manner. Conciseness, clearness, and directness cha-
racterised his delivery ; while with illustration and
anecdote he made his dull subject fascinatingly inte-
resting. It was his custom to write out on a black-
board notes of the subject on which he was about to
speak — concise, pithy headings, which were hung up
in the theatre and which he proceeded methodically to
explain and enlarge upon. So successful were his
efforts that even in the first session he was able to
make the proud boast that his class was for the first
time in its history the largest in the University, and
this in spite of the fact that one of the leading pro-
fessors altered his lecture hour to the same hour as
Simpson's, with the purpose of injuring the attendance
at Simpson's class.
A direct result of the reputation obtained through
his course of lectures and improved professional posi-
tion was the rapid increase of his practice and the
improvement of the class of his patients, so that
pecuniary profit came within his reach. He con-
67
SIR JAMES SIMPSON
tinued to be a general practitioner, however, attending
to all classes of cases that came to him ; but his zeal
for midwifery and the diseases of women, together
with his renown in those subjects, brought mostly
patients of the female sex to his consulting-room.
With the improved position there came necessarily
increased expenditure, which at first exceeded the
income ; he never stopped to consider the patients'
circumstances or whether he was likely to be paid for
his services. " I prefer to have my reward in the
gratitude of my patients," he said. He treated all
that came to him, and his generous nature was often-
times taken advantage of by persons very well able to
remunerate him ; moreover, at this time, when his
pecuniary profit did not equal his professional repu-
tation, he cheerfully helped many who appealed to
him with amounts he could ill spare.
His father-in-law generously and willingly stood by
him until the fees began to come in more freely — his
brother Sandy, who had supported him hitherto, having
now other claims upon his purse. He found two ordi-
nary but costly steps advisable — first, to move into a
better and more centrally situated house ; and, secondly,
to obtain a carriage, " both to support my rank among
my wealthier compeers and to save my body from
excess of work." The outlay was justified in the
result ; the fees from students and from his private
practice very soon enabled him to repay the debts to
his brothers and his father-in-law without incon-
68
PROFESSOR AND PHYSICIAN
venience and with grateful pleasure. Once and for
ever within the first few years of his professorship
he placed himself in a safe position, free from all
pecuniary anxiety.
If he had laboured hard to fit himself for the front
rank of his profession, his work on attaining that
position showed increase rather than abatement. His
private practice alone was the work of more than one
ordinary individual, and his professorial duties took up
some of the best hours of his day. In the evenings
and at all odd times he busied himself with absorbing
current or ancient literature, or in preparing his own
contributions to both professional and general know-
ledge either with the pen or by experiment. "Oh
that there were double twenty-four hours in the day,"
he sighed at a time when he was working at highest
pressure, practising amongst peers, commoners, and
cottagers alike, who all flocked to his residence or
sent long distances for him. When Princess Marie
of Baden, wife of the Duke of Hamilton, came
under his special care in 1843 ^^ ^^^^ ^^^^ ^^ ^^^
placed at the top of his profession in Scotland, and
must have smilingly recalled the words of old Dr.
Dawson, of Bathgate, when he heard of the successful
contest for the Chair. " It's all very well," he had
said, " to have got the Chair ! But he can never have
such a practice as Professor Hamilton. Why, ladies
have been known to come from England to consult
him!"
69
SIR JAMES SIMPSON
They came from the furthest parts of Greater
Britain to consult Hamilton's successor, in spite of
the old doctor's prognostication !
The energy as well as the versatility of the man is
well shown in the works which he found time to
carry on while he was thus establishing himself as a
teacher and as a practitioner, during the years from 1840
to 1845. One of his first literary efforts, not wholly
professional, the Memoir on "Leprosy and Leper-
Houses," was produced at that time. It was a work
of relaxation and pleasure, for it carried him deeply
into his favourite archaeology. The fascination which
this subject always had for him sprang from his love
of nature, and of the greatest work of nature —
man. "The leading object and intent of all the
antiquarian's pursuit is man," he said, "and man's
ways and works, his habits and thoughts, from the
earliest dates at which we can find his traces and
tracks upon the earth, onwards and forwards along the
journey of past time. During this long journey he
has everywhere left scattered behind him and around
him innumerable relics forming so many permanent
impressions and evidences of his march and progress."
The quantity and quality of the information con-
cerning leper hospitals which he collected and em-
bodied in his memoir, contributed to the Edinburgh
Medico-Chirurgical Society in March, 1841, was
phenomenal. He had consulted old manuscripts and
registers, monastic chronicles, burgh records, and Acts
70
PROFESSOR AND PHYSICIAN
of Parliament, as well as works of antiquity, travel,
and history. He gave close upon five hundred refer-
ences, as well as a list of one hundred and nineteen
leper-houses, whose existence in Britain and whose
history he had traced. The work illustrates the
objects and proper methods of antiquarian research,
which twenty years afterwards he dilated upon in his
address from the Chair of the Scottish Society of
Antiquaries. In the course of it he pointed out how
vigorously our ancestors had set to work to stamp out
the disease when it spread through Europe during the
period from the tenth to the sixteenth century. The
m.ethod adopted was that still employed — segregation ;
about the twelfth century scarcely a town or burgh in
France and Britain was without its leper-hospital.
Although we in Britain are happily now freed from
its ravages, other parts of the world are not so fortu-
nate. It is still regarded popularly as an incurable
disease, as it was in 1597, when one Catherine Living-
stone was gravely brought to trial for witchcraft, one
instance of which had been that she dared to state her
ability to cure " leprosie, which the maist expert men
in medicine are not abil to do." The indictment set
forth that she "took a reid cock, slew it, baked a
bannock with the blude of it, and gaf the samyn to
the leper to eat." The witch's remedy is scarcely
more curious and certainly no less useful than those
recommended two centuries later by John Wesley in
his " Primitive Physic," where, moreover, he cheer-
7^
SIR JAMES SIMPSON
fully, if somewhat too briefly to satisfy the modern
inquirer, reports the cure " of a most desperate case "
by the drinking of a half-pint of celery-whey morning
and evening.
Scotland was severely smitten by leprosy in the
centuries when it overspread Europe ; Robert Bruce
fell a victim to it in 1 339, and the disease seems to
have lingered in the North after it had almost vanished
from England.
Simpson's paper was published in the Edinburgh
Medical and Surgical Journal in three parts in 184 1
and 1842, and to this day is the most valuable contri-
bution to the interesting and important history of the
disease. Some of the information had been collected
in his student days. In his antiquarian researches he
had frequently met with references to the dirty and
unwholesome habits and surroundings of Scots towns
in early days. The thought that dirt and disease were
directly connected — a new thought even so recently as
fifty years ago — led to his investigations. He found
that leprosy was most prevalent at the time when his
country was most dirty ; but he was not able to
establish his supposition that the cause of the disease
lay in the insanitary surroundings of the people ;
indeed his researches proved that, on the contrary,
leprosy had declined and practically disappeared from
the country long before any material improvement in
sanitary conditions took place.
Simpson's conduct when Professor Thomson resigned
72
PROFESSOR AND PHYSICIAN
the Chair of Pathology illustrates the vigour with
which he entered into quite casually arising incidents
where he saw that strength and a fight were necessary
to conquer an evil or prevent an abuse. Thomson
resigned in 1841 owing to ill-health. The Chair had
been established by WiUiam IV. in 1831 on the repre-
sentations of Thomson himself, who succeeded in
satisfying Lord Melbourne that the subject was worthy
of the dignity of a separate Chair, in spite of the
protests of the Senatus Academicus, who throughout
the history of the medical faculty generally appear to
have been actuated more by personal considerations and
professional jealousies, where new developments were
in process, than by zeal for their Ahna Mater. Pro-
fessors Syme and Alison actively led an agitation that
with Thomson's resignation the separate teaching of
pathology should be brought to an end. Without a
moment's hesitation, in the midst of his hard work,
and suffering from indifferent health, Simpson plunged
into a controversy with these colleagues, in which he
silenced at once and for ever the detractors who had
sneered at him as an ignorant, uncultured man-
midwife. The controversy as usual was followed
with intense interest by Edinburgh folks, and Simpson
received a first taste of that popular approval which
undoubtedly was one of the enjoyments of his life.
The Crown avoided the difficulty of deciding between
the rival petitioners for and against the Chair by
transferring its patronage to the Town Council, who
73
SIR JAMES SIMPSON
showed the same foresight which had led them to
appoint Simpson, in deciding to maintain its existence.
Unfortunately their wisdom failed when they elected
as Thomson's successor a man who, although of
briUiant attainments, subsequently brought discredit
upon his University and himself by becoming a convert
to homoeopathy. Simpson, who was indirectly instru-
mental in securing the Chair of Pathology for this
man became his bitterest opponent when he declared
himself a follower of Hahnemann's unorthodox and
mistaken doctrines.
In 1842 it fell to Simpson's lot to deliver the
customary address to the medical graduates after they
had received their degrees at the annual ceremonial on
on the 1st of August. He treated his listeners to a
discourse on the duties of young physicians. When
we remember that he had attained to his then high
professional position while he was no more than a
young physician himself, we recognise that he was but
setting forth the ideals and principles which had been
and still were his guides in life and conduct.
After warning his audience against regarding the
gaining of the coveted degree as the end of their
student career, instead of as in reality the opening up of
a Hfetime of observation and study, he pointed out that
self-patronage was the best of all patronage. " Place
from the first," he said, "all your hopes of advance-
ment upon the breadth and extent of your medical
abilities alone. . . Rather walk by the steady light of
74
PROFESSOR AND PHYSICIAN
your own lamp than by the more dazzling, but to you
more uncertain, lustre borrowed from that of others. . .
Young physicians often dream that by extending the
circle of their private acquaintances they thus afford
themselves the best chance of extending the circle of
their private patients. . . No man will in any case
of doubt and danger entrust to your professional
care the guardianship of his own life or of the life of
those who are near and dear to his heart, merely
because you happen to be on terms of intimacy with
him. The self-interest of human nature forbids it. . .
The accomplishments which render you acceptable in
the drawing-room are not always those that would
make your visits longed for or valued in the chamber
of sickness and sorrow. . . Give therefore your whole
energies to medicine ; and in its multiplied departments
you will find ^ ample room and verge enough ' for the
most energetic as well as the most comprehensive
mind. Place your faith in no extrinsic influences.
Let your own professional character be the one great
patron to whom you ever look for your professional
advancement." He exhorted the young practitioners
above all to save and economise their time, and to
regard it as a property to be avaricious of and of every
item of which they were to render a proper account to
themselves. " It is by carefully preserving, confirming,
and making diligent use of these broken and disjointed
portions of it, which others thoughtlessly waste and
destroy, that almost all the highest reputations in the
75
SIR JAMES SIMPSON
medical profession have been formed." He strongly
urged the value of a " proper covetousness of time."
" Look around, and you will find that those who have
the most to do in the way of business as practitioners
have also apparently the most time to spare as observers
and writers. . . And why ? Because they have all
their daily duties perfectly assorted and arrayed ; they
save from loss and destruction every possible fragment
of time ; and this very industry and precision procures
them more true leisure than indolence can boast of."
In referring to the relation of practitioner to
patient, he spoke on a subject which has been much
discussed in recent years without altering the
principle originally laid down in the oath of Hippo-
crates : — "Whatever," said Simpson, "is communicated
to you as a' matter of professional confidence, must
ever remain buried within your own breasts in all the
silence and secrecy of the grave." He concluded his
address with well-judged remarks on the relation of
the physician to his professional brethren, counselling
his hearers to observe the Golden Rule, and, moreover,
" if it be possible, as much as lieth in you, live peace-
ably with all men ; never allow the darker part of
your nature to persuade you to the attempt of over-
taking him who has distanced you in the race of life
by any unjust efforts to lame the character, and thus
diminish the speed, of your adversary. And if such
attempts are made upon you by others, have no dread
of them — if you are armed strong in honesty, if you
76
PROFESSOR AND PHYSICIAN
have pursued a line of irreproachable truth and un-
bending rectitude of conduct. ' Be thou as pure as
snow thou shalt not escape calumny.' . . . Your
future career is a matter of your own selection, and
will be regulated by the conduct which you choose to
follow. That career may be one of happiness or self-
regret, one of honour or of obscurity, one of wealth
or of poverty. The one or other result is not a
matter of chance^ but a matter of choice on your part.
Your diligence and industry for the next few years
will almost inevitably secure for you the one ; your
apathy and indolence will almost inevitably entail
upon you the other. May God, in His infinite
goodness, enable you to select the wiser and the
better path."
In this address, as in that previously quoted, we
hear him exhorting his young listeners to a line of
conduct which we know to have been broadly his own
in practice as well as in ideal. During these early
years as professor, Simpson had to ward off many ill-
disposed adversaries, and he met their attack with the
determination and powerful preparedness that charac-
terised his attitude in later years, when he experienced
the hostility so constantly opposed to genuine re-
formers, and men who have lived ahead of their tim.es.
He sometimes regarded these encounters regretfully
himself ; but none the less remembered to
" Bear't that the opposed may beware."
The correspondence pertaining to some of these
11
SIR JAMES SIMPSON
disputes was filed and ticketed, with brief contempt,
" Squabbles." His controversy with Professor Syme
over a personal matter in 1845 was not to the credit
of either of these great men, and, as Simpson himself
confessed, was equally discreditable to their profession.
Simpson had seen, as has been pointed out, several
of his teachers fighting long and strongly for their
own cherished objects ; and he doubtless then, in
his student days, learnt the lesson that vigorous per-
sistence had the power to gain much that at first
seemed hopeless ; he fought with such energy, that he
accomplished in his own lifetime what the example
of others might have led him to think would have
been accomplished only by his successors.
The growth of his practice up to 1847 ^^^ little
short of phenomenal. In 1845 he purchased No. 52,
Queen-street, the house which he inhabited up to his
death, and which became the Mecca of hundreds
upon hundreds of pilgrims from all quarters of the
globe. Here, in those years, he was sought and
consulted by unceasing crowds ; in the public mind
he was undoubtedly endowed with more than human
powers, and regarded as a magician, at the wave of
whose wand pain and disease would vanish. This
caused him much embarrassment, and brought upon
him the abuse of ignorant persons, irritated to find
that, after all, even in Simpson's person, there was a
limit to human powers ; or of others with unimportant
ailments who were disappointed to find that, once
78
PROFESSOR AND PHYSICIAN
having made his diagnosis of their condition, he would
have no more of them, preferring to place his time at
the disposal of those whose sufferings were real and
capable of relief, or whose cases were complicated and
interesting. The question of remuneration was always
secondary, and so careless was he in pecuniary matters
that it is related that he would wrap up interesting speci-
mens, professional or antiquarian, in bank notes ; and his
trusted valet was in the habit of emptying his pockets
at night of the money earned in the day, to prevent
its being lost, mislaid, or given away to undeserving
persons. With him work was first and fee second.
Like a great modern teacher he was able to say,
" Work first — you are God's servant ; fee first — you
are the fiend's." To Simpson " work was master and
the Lord of Work, who is God."
The personal power and attractiveness of the man
were large factors in gaining the practice which he
now enjoyed. But he did not depend for success on
these alone, by any means. His professional reputa-
tion was fully won by great work in obstetrics and
gynaecology, and by the introduction of methods and
instruments which contributed to the saving of count-
less lives. It has been said that he gave a new life to
the obstetric art, and presided at the birth of gynaeco-
logy. He had done this before the great deed was
dreamt of which hands his name down to posterity,
before his discovery of the anaesthetic power of
chloroform. Simpson was a great physician, the
79
SIR JAMES SIMPSON
leading practitioner of the art and exponent of the
science with which his name will always be con-
nected. But many great physicians have failed to
fulfil as Simpson did, Robert Louis Stevenson's
description of the physician : —
" Generosity he has such as is possible to those who
practise an art, never to those who drive a trade ;
discretion tested by a hundred secrets ; tact tried in
a thousand embarrassments ; and what are more
Heraclean cheerfulness and courage. So it is that he
brings air and cheer into the sick room, and often
enough, though not so often as he wishes, brings
healing."
Great as a man and great as a physician, Simpson
was actually run after by the greatest in the land. In
1845 he was summoned professionally to London, and
gave an interesting description of his kindly reception
by the Duchess of Sutherland and her family in a
letter written from Stafford House. His advent to
London was a matter of notoriety, and he noted that
he bought in the street a life of himself which
mightily diverted him and made him laugh until he
was sore. A year or more later he was invited for
rest and change to Erskine House by Lord Blantyre,
where he says, " the Duchess of Sutherland, the
Marquis and Marchioness of Lome, and two Ladies
Gower have made up with myself all the strangers."
" Tell Janet," he wrote to his brother, " I think now
artificial flowers very ungenteel. The ladies here
80
PROFESSOR AND PHYSICIAN
wear nothing but real flowers in their hair, and every-
day they come down with something new and for us
males to guess at. Often the Duchess wears a simple
chaplet of ivy leaves, sometimes a bracken leaf is all
she sports in her head ornaments, and beautiful it
looks. Rowans and ' haws ' are often worn beaded
into crov/ns or flowers or chaplets. Heather is also
a favourite. On Thursday Lady Lome came down
with a most beautiful chaplet tying round and keeping
down her braided hair. It was a long bunch of
bramble leaves and half-ripe bramble berries — actual
true brambles. They have been all exceedingly kind
to me, and I really feel quite at home among them
though the only untitled personage at table."
The daily scene at 52, Queen Street was now
unique. Those who had the fortune to lunch or
breakfast in that hospitable house never forgot it.
Statesmen, noblemen, artists, scientists, clergymen,
and politicians from various countries sat down
together and entertained each other or attempted to
do so in their different languages. The host guided
the conversation while he still glanced over the news-
paper or some newly published book, and never failed
by skilful leading to entice out of every one the best
knowledge that they possessed. With his quick
insight he rarely failed in his estimate of character,
but rapidly perceived even in a stranger where the
conventional ceased and the real man began.
No stranger to Edinburgh omitted to bring or
81 G
SIR JAMES SIMPSON
obtain an introduction to the genial professor ; aU
were welcome, and an open table was kept. The
scene has been described from intimate knowledge
in the columns of the Scots Observe?- as follows : —
" Luncheon is set on the table, and some ten, twenty,
or even fifty people wait the appearance of their host,
who is on his rounds maybe, or in another room
ministers to an urgent case. A stranger who has not
learnt that the great Simpson was only in the broadest
sense a punctual man — of minutes, hours, he knew
nothing, but none more reliably punctual, few so
unsparingly regular in working while 'tis called to-day
— might be prompted by hungry discontent to suggest
that none but the wealthiest can keep the doctor from
his guests. The mere suggestion would be infamous,
for rich and ragged alike pay fees or not exactly as it
pleases them. Whatever the cause, the host still
lingers, and the impatient stranger has time to wonder
how it is that so odd an assortment of human beings
should be met together in one room. Lords and
Commons rub shoulders at his table ; the salt of the
earth sit down side by side with the savourless ; tweed
jostles broadcloth ; the town-bred Briton looks ask-
ance at his country-bred compatriot, and both uncon-
sciously shudder at the Briton with no breeding at all.
In one room are assembled together the American of
bluest blood ; the Yankee bagman ; the slave-owning
Southerner, and even the man of colour hateful to both
alike. The atmosphere is chili hke the grave, each
82
PROFESSOR AND PHYSICIAN
guest, eyeing his neighbour suspiciously, shrinks into
his own social shell ; on each face the meanness and
snobbery of humankind is, if not aggressively expressed,
at least clearly legible ; when all at once Simpson
bustles in. In a few minutes, under the genial influ-
ence of his presence, all tongues are set a-wagging,
and well may you ask whether the men who leave his
house after luncheon are those who half-an-hour ago
regarded each other with cold disdain. For now
they are cordial, kindly, sympathetic ; each has been
induced to show whatever was' attractive in his nature,
or to give the fruits of his experience. If in one short
hour Simpson could thus transform a crowd of frigid,
haughty strangers into an assemblage of decent,
amiable human beings, what could he not achieve in a
day, a year, or a life ? "
His reception of members of his own profession was
specially cordial, and if those from any one country
were more welcome than others, it was the many who
crossed the Atlantic to see and hear him. America
had the greatest share in the birth of anaesthetics, and
Simpson's intimacy with so many of the profession in
the United States made it easy for them to welcome
his assistance in that great event. Gynaecology, too,
was eagerly taken up in America, and many were
Simpson's admirers from that country who returned
home fired by his influence to work out for them-
selves valuable additions to that science.
Simpson paid close attention to current events in
83
SIR JAMES SIMPSON
other branches of science, in politics, and in religion.
Sir Robert Christison and he were at one time asso-
ciated in an enterprise which narrowly escaped being
the source of a fortune to him. Rangoon petroleum
which was obtained from pits dug on the banks of the
Irawaddy had been chemically investigated by Christi-
son, and he had isolated from it a substance which he
named petroline ; unfortunately, unknown to him, a
German chemist had independently made the same
discovery a few months earlier, and christened the
substance paraffin. When, a few years later, it oc-
curred to Simpson that the crude Rangoon petroleum
might serve as a lubricant for machinery and prove
cheaper than those in general use, he applied to
Christison. He met with willing assistance, but a
refusal on principle to have anything to do with a
patent, which Christison laughingly suggested, might
be called " Simpson's incomparable antifriction lubri-
cant ! "
" When I called for Simpson," says Christison, in
his Recollections, " his two reception rooms were as
usual full of patients, more were seated in the lobby,
female faces stared from all the windows in vacant ex-
pectancy, and a lady was ringing the door bell. But
the doctor brushed through the crowd to join me, and
left them all kicking their heels for the next two
hours."
Their experiments proved that petroleum was vastly
superior to sperm oil, the best known and most com-
84
PROFESSOR AND PHYSICIAN
monly used lubricant. Simpson proceeded to take out
a patent, having no such scruples as Christison ; but
to his chagrin found that he had been forestalled by
others, and had to abandon the subject.
About the period now referred to Scotland was
stirred from end to end by the ecclesiastical movement
which culminated in the crisis known as the Dis-
ruption, when, for reasons connected with the juris-
diction of the National Church, a majority of its
members severed their connection therewith in a
public and dramatic fashion, and " came out " to
found the now strong and vigorous Free Kirk. Simp-
son at first steered clear of all the squabbles and
discussions which the movement gave rise to, but
when affairs approached a crisis he threw his lot in
with the leaders of the new movement, and became a
staunch Free Churchman.
Busy as he was, Simpson fully enjoyed his home and
all the inner domestic life. He was a cheery and
hearty host to his intimate friends, and took a pleasure
in impromptu entertainments got up by himself in his
own house, when he found time at his disposal for such
amusement. His first child — a daughter — of whom
he was mightily proud, was born in 1840 ; his first
son, David, in 1842 ; and the second, Walter, in 1843.
In 1844 the young couple, in the midst of their
rising prosperity, suffered the loss of their daughter,
who died after a brief illness. Simpson felt the loss
keenly, and wrote pathetically on the subject to his
85
SIR JAMES SIMPSON
relations ; long afterwards he loved to talk of her and
her winning ways.
By 1846 the vast majority of his work lay in
obstetrics and gynaecology, although he himself would
no doubt have indignantly repelled the suggestion
that he was a specialist ; his mind recognised the
interdependence of all the great branches of the
healing art, and the necessity for any who wished to
excel or be useful practitioners to be au courant with
each and every branch. He had early shown that as
a pathologist alone he was worthy of a niche in the
temple of fame ; and in later days he was urged to
apply for the vacant chair of Physic in his own Uni-
versity ; while Professor A. R. Simpson tells us that
foreigners working in the sphere of surgery sometimes
spoke of him as a surgeon.
Early in 1847 his good friend, the Duchess or
Sutherland, wrote to inform him that the Queen had
much pleasure in conferring upon him the vacant post
of Physician to Her Majesty. In the Queen's own
words, " His high character and abilities made him
very fit for the post." He held this post until his
death, under the title of Physician Accoucheur to the
Queen for Scotland.
Thus in his thirty-sixth year, to the pride of his
family and of the whole village community in which
he had been born and received his early training, to
the admiration of patients and friends, as well as to
his own conscious satisfaction, the Bathgate baker's
86
PROFESSOR AND PHYSICIAN
son had risen by his own efforts to the highest
attainable position in his native land. But the work
which was to make him one of the most conspicuous
figures in the history of medicine, and raise him
to a place of honour in the grateful estimation of
humanity, was scarcely begun.
CHAPTER VI
The Discovery of Anaesthetics, i 844-1 847
His early sympathy for suffering — Surgical methods before the discovery
of anaesthetics — His mental struggle caused by the sickening
sights of the operating theatre — His researches into the history of
anaesthesia — Indian hemp — Mandrake — Alcohol — Hypnotism and
other methods — Inhalation of drugs — Sir Humphry Davy — Anaes-
thetics discovered in Am.erica — Horace Wells and laughing-gas —
Morton and ether — Ether in Great Britain — He uses it in midwifery
practice — Search for a better anaesthetic — Discovery of anaesthetic
power of chloroform.
FROM his earliest student days the desire had
ever been present in Simpson's mind to see
some means devised for preventing the sufferings
endured by patients on the operating table, without,
as he put it, " interfering with the free and healthy
play of the natural functions." It is difficult for us at
the close of the nineteenth century to understand,
without an effort of the imagination, the strong in-
centives which he had for such a wish. Even to-day,
when operations are conducted without the infliction
of pain, young students are not unfrequently overcome
by the sight and the thought of what is in front of
88
THE DISCOVERY OF ANAESTHETICS
them. At the commencement of a winter session the
theatre is crowded with those students who are enter-
ing upon surgical study, and with others, not so far
advanced, who have come to get a preliminary peep
at the practice of this fascinatingly interesting art.
Many of these at first succumb and faint even before
the surgeon has begun his work, and sometimes are
only persuaded to pursue their studies by the encour-
agement of kindly teachers.
Simpson also went through this trying experience,
but it must have been a greater struggle to him to
persist. The surroundings of the surgeon at the
commencement of the century were vastly more re-
pugnant to a youth of sensitive nature than to-day.
The operating theatre then has been compared to a
butcher's shambles ; cleanliness was not considered
necessary, and little attention was paid to the feelings
of the patient. He was held down by three or
four pairs of powerful arms as the surgeon boldly
and rapidly did his work, despite the screams,
stopping, perhaps, only to roughly abuse the patient
for some agonised movement which had interfered
with the course of action. The poor wretch saw
the instruments handed one by one by the assistant,
and heard the surgeon's calm directions and his
remarks on the case. The barbarous practice of
arresting bleeding by the application of red-hot irons
to the surface of the wound had indeed ceased three
centuries before, when that humane reformer. Pare,
89
SIR JAMES SIMPSON
displaced it with the method of tying the open blood-
vessel, but the patient's blood gushed forth before him
until arrested, into the sawdust spread to receive it,
and the sight and the hot odour of it oftentimes merci-
fully caused him to faint. The spirit of Pare who,
when relating a successful operation, would humbly
add at the end, " I dressed him ; God healed him,"
had not descended to those who practised in Simpson's
day the art for which Pare did so much. It had grown
to be necessary for a surgeon to be rough and callous ;
it was expected of him by the public ; he was a man
to be pointed at in the street, and shuddered at when
he passed, by all v/ho devoutly prayed they might
escape his clutches. Much of this conduct was mere
mannerism ; it had become the custom, and had to
be maintained in order to preserve the dignity and
stamp the identity of the surgeon. Much of it arose
from the haste with which the surgeon had to work ;
the quicker the operation the better chance had the
patient ; it v/as no uncommon thing to see a bystander
timing the surgeon's work, as the professional time-
keeper carefully times a race ; and the rapidity of each
surgeon's performances was a subject of comparison
and admiration amongst the students of his day.
Much of it also arose from the effect of the hideous
scenes in the operating room upon the surgeon
himself; his nerve had to become of iron if he desired
to succeed, and with the nerve the face and the
manner, but not necessarily always the heart hardened
90
THE DISCOVERY OF ANAESTHETICS
also. Tennyson possibly recollected these days, when
he wrote of the surgeon who
" Sent a chill to my heart when I saw him come in at the door,
Fresh from the surgery schools of France, and of other lands ;
Harsh red hair, big voice, big chest, big merciless hands."
When Simpson first saw Liston raise his knife to
operate on a poor Highland woman, he actually felt so
repelled that he contemplated abandoning his studies,
and made a serious attempt to enter upon legal work
instead. But the mental struggle with which medical
men of all countries, and in all times, can sympathise
out of their own knowledge, ended in a victory for
medicine, and a triumphant return to his studies with
the question permanently engraved on the tablets of
his mind, " Can nothing be done to prevent this
suffering ? "
It is necessary and it is certainly beneficial that we
should thus remind ourselves of the horrors which
surrounded the surgeon so recently as sixty years ago.
" Before the days of anaesthetics," wrote an old
patient to Simpson, in a letter which he treasured with
pride — the writer was himself a medical man — " a
patient preparing for an operation was like a con-
demned criminal preparing for execution. He counted
the days till the appointed day came. He counted
the hours of that day till the appointed hour came.
He Hstened for the echo in the street of the surgeon's
carriage. He watched for his pull at the door bell j
91
SIR JAMES SIMPSON
for his foot on the stair ; for his step in the room ; for
the production of his dreaded instruments ; for his few
grave words, and his last preparations before beginning.
And then he surrendered his liberty and, revolting at
the necessity, submitted to be held or bound, and
helplessly gave himself up to the cruel knife.".
It was, indeed, a monstrous ogre this giant Pain,
holding the poor weak human creature in its merciless
clutches, which Simpson even in his youthful days
bethought himself to attack. It is well that we
who are the heirs, should know how Simpson and
those others whose names are ever associated with his,
slew the monster, won the victory, and championed
the human race forward into a land where further
victories undreamt of by themselves are now being
daily won.
Simpson searched into ancient history in order to
ascertain the methods, if any, by which in remote and
mediaeval times surgeons sought to prevent the pain of
operations. The most time-honoured method seems
to have been by the internal administration of drugs,
the chief one used being Indian hemp, which was well
known in the East, and under one of its names
haschish gave origin to the term assassin (strictly eater
of haschish). A certain Arab Sheikh got together a
band of followers to whom he administered haschish,
which produced in them its usual effect — beautiful
dreams of a delightful paradise. He induced them to
believe so thoroughly in his power to gain for them at
92
THE DISCOVERY OF ANESTHETICS
death permanent entrance to this paradise that they
obeyed all his ferocious and bloodthirsty behests.
Thus these assassins became known as men obedient
to their leader in any murderous enterprise. Indian
hemp was, and still is, used as a luxury all over the
East, as well as to annul pain, and was used by
criminals doomed to torture or execution. Simpson
thought the nepenthe of Homer was a preparation of
this drug ; he also refers to the fact that Herodotus
relates that the Massagetas inhaled the vapour of
burning hemp to produce intoxication and pleasurable
excitement.
Mandrake was used in a similar manner and for
similar purposes as Indian hemp in the Middle Ages,
but it fell into disuse on account of the fatal results
that often followed. It is frequently referred to by
Shakspeare both for its narcotic properties and for its
fabulous power of uttering a scream when torn up by
the roots, to hear which meant death or madness.
Simpson cited also well-known passages from Shaks-
peare to prove that the practice of " locking up the
spirits a time " was known to that poet.
In later days the intoxication produced by alcohol
was taken advantage of, and instances of its use have
been known in quite recent years in the Colonies,
where both a surgeon and chloroform were out of
reach.
No drug, however, was known to be of such value
in producing anaesthesia as to be constantly used, and
93
SIR JAMES SIMPSON
many trials were made of other means, notably that
of compressing the nerves supplying the part to be
operated upon, but this was found to be too painful in
itself. The stupor produced by compressing the
carotid arteries — a method taken advantage of by the
ruffians known as garotters — was also put in practice
for a time during the sixteenth and seventeenth cen-
turies, but it was found too barbarous a method even
for those days.
Hypnotism was known to the Indians, Egyptians,
and Persians at a very remote period, and may possibly
have been used by them sometimes to produce anaes-
thesia for surgical purposes. Simpson was attracted by
the words of the poet Middleton in his tragedy
" Women, beware Women " (1617) where he says —
" I'll imitate the pities of old surgeons
To this lost limb — who ere they show their art
Cast me asleep, then cut the diseased part."
When hypnotism made one of its periodic re-ap-
pearances in 1837, this time under the name of
mesmerism, after that extraordinary exponent of its
powers Mesmer, Simpson recognised in it a possible
method for " casting the patient asleep " before opera-
tion and set to work to investigate its phenomena.
A Frenchman named Du Potet, disheartened by the
prejudice against mesmerism in his own country,
came to London in 1837, and was fortunate enough
to receive the support of Dr. John Elliotson, physician
94
THE DISCOVERY OF ANESTHETICS
to University College Hospital. EUiotson's advocacy
of the new practice was received with ridicule by
the profession, and was treated with such scathing
contempt by the Lancet and other journals, that he
was completely ruined.
Simpson was very successful in his experiments with
mesmerism, conducted on the lines suggested by
Elliotson, but he recognised that, after all, it was not
the agent for which he was seeking, and dropped his
researches.
He did not resume them even when Liston, a few
years later, stimulated by the advocacy of the Man-
chester surgeon Braid, v/ho met with a better reception
than Elliotson, and by the relation of a long series of
successful cases by a surgeon named Esdaile, in Calcutta,
actually performed operations with success on patients
brought under its influence.
The first suggestion to produce anaesthesia by the
inhalation of drugs was made by Sir Humphry Davy
in 1800. He discovered by experiment upon himself
that the inhalation of nitrous oxide gas — commonly
known as a laughing gas — had the power of relieving
toothache and other pains ; he described the effect as
that of " uneasiness being swallowed up for a few
minutes by pleasures." Although he stopped short at
this stage, and does not seem to have used the inhala-
tion to produce actual loss of consciousness, he, never-
theless, forecast the future by suggesting that nitrous
oxide might be used as an inhalation in the performance
95
SIR JAMES SIMPSON
of surgical operations, in which " no great effusion of
blood " took place.
Some thirty years later Faraday pointed out that
ether had effects upon the nervous system when inhaled,
similar to those of laughing-gas. These two drugs
came to be inhaled more in jest than in earnest ; more
as an amusing scientific experiment for the sake of
the pleasure-giving excitement they set up, than for
the purpose Davy had suggested. Ether, it is true,
was recommended even before Davy's day for the
relief of the suffering in asthma, but until the fifth
decade of the century no one had attempted to prevent
suffering as inflicted by the surgeon or the dentist, by
producing the state of unconsciousness brought about
by the inhalation of such drugs as ether — a process
now known to' the world as anaesthesia.
The persons who first made the bold experiments
which resulted in the discovery of how to produce
anaesthesia were Americans ; and two men were
prominently concerned in the discovery. Several
others made isolated and successful efforts with both
ether and nitrous oxide, but they lacked the confidence
and the courage to make their success public and to
persist in their experiments. Of these, Dr. Long, of
Athens, Georgia, was one of the earliest ; he is said to
have successfully removed a tumour from a patient
under the influence of ether in 1842, and in the
Southern States he is regarded as the discoverer of
anaesthesia. Dr. Jackson, of Boston — a scientific
96
THE DISCOVERY OF ANAESTHETICS
chemist — laid claim to the honour of the discovery
after others had fought the fight and established the
practice of anaesthesia. Neither of these men, for
the reason already given, deserves the honour which is
now universally attributed to their fellovz-countrymen,
Wells and Morton.
Horace Wells was born at Hartford, Connecticut, in
1 8 15, and was educated to the profession of dental
surgeon. He gave much attention to the desire
present in the minds of many men at that time to
render dental operations painless. On December 10,
1844, he witnessed at a popular lecture the experiment
of administering laughing-gas, and noticed that a Mr.
Cooley, while still under the influence of the gas, struck
and injured his limb against a bench without suffering
pain. The idea at once occurred to Wells that here
was the agent he was in search of, and the very next
day he experimented upon himself. If it has ever
been fortunate to have toothache it was so for Wells
that day ; he was troubled by an aching molar which
was removed by a colleague named Rigg, whilst he
was fully under the influence of nitrous oxide ; and
thus he began what he himself at once called on recover-
ing consciousness, " a new era in tooth-pulling." He
proceeded promptly to test the experiment upon others
and with complete success ; and then making his
success known, he proceeded with his former pupil
Morton to Boston, and gave a public demonstration of
his method which unfortunately was so imperfectly
97 "
SIR JAMES SIMPSON
carried out that he was laughed at for his pains and
stigmatised aji impostor. Wells himself stated that
the failure was due to the premature withdrawal of the
bag containing the gas, so that the patient was but
partially under its influence when the tooth was
extracted. Wells and Morton were ignomijiiously
hissed by the crowd of practitioners and students
gathered to see the operation. Wells never recovered
from the disappointment and the illness which resulted,
and although he was able to explain his discovery to
the French Academy of Science in 1846, he unfortu-
nately died insane in New York two years later. Un-
doubtedly he was the first to discover the practicability
of nitrous oxide anaesthesia, and to proclaim the dis-
covery with a discoverer's zeal. Although his career
ended so sadly, his efforts had, nevertheless, inspired to
greater endeavour liis colleague Morton, who had not
only been associated in his experiments, but had
been deeply interested in the subject for many
years.
William Thomas Green Morton was born in 1 8 1 9 ;
his father was a farmer at Charlton, Massachusetts.
He qualified as a dentist at Baltimore, and entered
into successful practice at Boston. Fired with the
same ambition as Wells, he made attempts to extract
teeth painlessly with the assistance of drugs administered,
or sometimes of hypnotism. In December, 1844, ^^^^^'
Wells's failure with nitrous oxide gas, he wisely
abandoned that agent and investigated another which
98
THE DISCOVERY OF ANESTHETICS
promised better results. He experimented first with
a drug known as chloric ether^ but failing to get the
desired effect, and at the suggestion of the afore-
mentioned Dr. Jackson, he proceeded to investigate
the effect of ordinary ether. The first experiments
were made on animals, and were so encouraging that
he believed he had at last found the desired agent,
provided the effect on human beings corresponded with
that upon dumb creatures. Boldly and heroically he
made the necessary experiment upon himself, and on
September 30, 1846, inhaled ether from a handker-
chief while shut up in his room and seated in his own
operating-chair. He speedily lost consciousness, and
in seven or eight minutes awoke in possession of the
greatest discovery that had ever been revealed to
suffering humanity. We can picture the man
gradually awakening in his chair first to the con-
sciousness of his surroundings and then to the
consciousness of his great achievement ; sitting with
his physical frame excited by the influence of the drug
which he had inhaled, and his soul stirred to its
deepest depth by the expanding thought of the far-
reaching effects of what he had done.
" Twilight came on," he said, in subsequently
relating the event. " The hour had long passed when
it was usual for patients to call. I had just resolved to
inhale the ether again and have a tooth extracted
under its influence, when a feeble ring was heard at
the door. Making a motion to one of my assistants
99
SIR JAMES SIMPSON
who started to answer the bell, I hastened myself to
the door, where I found a man with his face bound up,
who seemed to be suffering extremely. ' Doctor,'
said he, * I have a dreadful tooth, but it is so sore I
cannot summon courage to have it pulled j can't you
mesmerise me ? ' I need not say that my heart
bounded at this question, and that I found it difficult
to control my feelings, but putting a great constraint
upon myself I expressed my sympathy, and invited him
to walk into the office. I examined the tooth, and in
the most encouraging manner told the poor sufferer
that I had something better than mesmerism, by
means of which I could take out his tooth, without
giving him pain. He gladly consented, and saturating
my handkerchief with ether I gave it to him to inhale.
He became unconscious almost immediately. It was
dark. Dr. Haydon held the lamp. My assistants
were trembling with excitement, apprehending the
usual prolonged scream from the patient, while I ex-
tracted the firmly-rooted bicuspid tooth. I was so much
agitated that I came near throwins; the instrument
out of the window. But now came a terrible reaction.
The v/renching of the tooth had failed to rouse him in the
slightest degree ; he remained still and motionless as if
already in the embrace of death. The terrible thought
flashed through my mind that he might be dead — that
in my zeal to test my new theory, I might have gone
too far, and sacrificed a human life. I trembled under
the sense of my responsibility to my Maker, and to my
100
THE DISCOVERY OF ANESTHETICS
fellow-men. I seized a glass of water and dashed it in
the man's face. The result proved most happy. He
recovered in a minute, and knew nothing of what had
occurred. Seeing us all stand around he appeared be-
wildered. I instantly, in as calm a tone as I could
command, asked, " Are you ready to have your tooth
extracted ? " " Yes," he ansvv^ered, in a hesitating
voice. " It is all over," I said, pointing to a decayed
tooth on the floor. " No," he shouted, leaping from
his chair. The name of the man who thus for the
first time underwent an operation under anaesthesia
induced by ether was Eben Frost."
The nature of the agent used by Morton was kept
secret only a short period ; the steps he took to bring
his discovery before the medical profession would have
rendered it difficult if not impossible, even if ether had
not a penetrating tell-tale odour. Morton laid his
method before one of the surgical staff of the Massa-
chussetts General Hospital, Boston, the same institution
where Wells's ill-managed demonstration had taken
place two years before ; he requested, with complete
confidence, to be allowed to exhibit the powers of his
agent. The surgeon v/as sceptical, but wisely con-
sented, after having satisfied himself that there was no
risk to life. A patient suffering from a tumour was
chosen, and readily consented to act as a subject for
demonstration. A large crowd of professional men and
students assembled in the surgical theatre on the morn-
ing of October i6, 1846, the day chosen for the trial.
lOI
SIR JAMES SIMPSON
The senior hospital surgeon, Dr. J. Collins Warren,
was to perform the operation. The spectators, many
of whom no doubt recollected the failure with laughing-
gas, were disposed to deride when the appointed hour
passed and Morton did not appear j but the delay was
due only to the desire of the dentist to bring a proper
inhaler, and although the crowd received him with a
chilHng reserve, and the occasion was one fit to try the
nerve of the strongest, Morton did not lose his pre-
sence of mind. He promptly anaesthetised the patient,
and as unconcernedly as does the modern administrator,
nodded to the surgeon that the patient was ready.
From the first moment that the knife touched the
patient, until the operation was concluded, no sound,
no movement indicated that he was suffering. The
men who had scoffed once and had come, even the
surgeon himself, prepared to scoff again, realised the
success and the wonder of it, and remained to admire.
" Gentlemen, this is no humbug," exclaimed Dr.
Warren, as he finished his handiwork. When the
patient recovered he was questioned again and again,
but stoutly maintained that he had felt no pain — abso-
lutely none. " Gilbert Abbott, aged twenty, painter,
single," was the description of the man on whom was
performed the first surgical operation under the
influence of ether.
News of the great success rapidly spread, and the
experiment was repeated by Morton and others in
America, and similar work was taken up throughout
102
THE DISCOVERY OF ANESTHETICS
Europe. It cannot be said that Morton derived much
benefit from his discovery. Although the greatness of
it was recognised in his Hfetime, and he received
several honours and presents, he entered into pro-
longed squabbles concerning the discovery w^hich
v^^orried him into a state of ill-health, ending in his
death in 1868. A monument was erected over his
grave by the citizens of Boston, bearing the following
concise description of his achievement : —
« WILLIAM T. G. MORTON,
" Inventor and revealer of anaesthetic inhalation,
By whom pain in surgery was averted and annulled ;
Before whom in all time surgery was agony,
Since whom Science has control of Pain."
Whilst the discoverer of nitrous-oxide anaesthesia
was dying from chagrin and inaction, and the revealer
of anaesthetic inhalation by ether was wasting time
in unworthy disputes concerning priority, and fruitless
endeavours to gain pecuniary reward, a bolder than
either had taken up the work where they had left it,
with the high object of pursuing it until he had for
ever established the benefit to humanity which he
recognised in it. He went straight forwards and
onwards, strong in his endeavour ; undeterred by the
jeers of the ignorant, the opposition of the prejudiced
or the attacks of the jealous, with no thought of or
wish for reward except that which was to come daily
from the depth of sufferers' hearts.
During the Christmas holidays of 1846 Simpson v/as
103
SIR JAMES SIMPSON
in London, and discussed the new discovery with
Liston, who was one of the first to operate under ether
in Great Britain at University College Hospital. The
great surgeon thought that the chief application of the
process would be in the practice of rapidly operating
surgeons j it was at first generally believed that the
inhalation could be borne for only a brief period,
Simpson speedily showed that no evil resulted if the
patient remained under the influence of the vapour for
hours. In the month of January, 1847, ^^^ gained for
the Edinburgh Medical School the proud honour of
being the scene of the first use of anaesthetics in
obstetric practice. In March of the same year he
published a record of cases of parturition in which he
had used ether with success ; and had a large number
of copies of his paper printed and distributed far and
wide at home and abroad, so eager was he to popularise
amongst the members of his profession the revolu-
tionary practice which he introduced. From the day
on which he first used ether in midwifery until the end
of his career he constantly used anaesthetics in his
practice. He quickly perceived, however, the short-
comings of ether, and having satisfied himself that
they were unavoidable, he set about his next great step,
namely, to discover some substance possessing the ad-
vantages without the disadvantages of ether. In the
midst of his now immense daily work he gave all his
spare time, often only the midnight hours, to testing
upon himself the effect of numerous drugs. With the
104
THE DISCOVERY OF ANAESTHETICS
same courage that had filled Morton he sat down
alone, or with Dr. George Keith and Dr. Matthews
Duncan, his assistants, to inhale substance after sub-
stance, often to the real alarm of the household at 52,
Queen Street. Appeal was made to scientific chemists
to provide drugs hitherto known only as curiosities of
the laboratory, and for others that their special know--
ledge might be able to suggest. The experiments
usually took place in the dining-room in the quiet of
the evening or the dead of night. The enthusiasts sat
at the table and inhaled the particular substance under
trial from tumblers or saucers ; but the summer of
1847 Passed away, and the autumn was commenced
before he succeeded in finding any substance which at
all fulfilled his requirements. All this time he was
battling for anaesthesia, which, particularly in its ap-
plication to midwifery, was meeting with what appears
now as an astonishing amount of opposition, on varying
grounds from all sorts and conditions of persons ; but
the vigour and power of his advocacy and defence of
the practice in the days when laughing-gas and ether
were the only known agents, were as nothing to that
which he exerted after his own discovery at the end of
1847.
The suggestion to try chloroform first came from a
Mr. Waldie, a native of Linlithgowshire, settled in
Liverpool as a chemist. It was a " curious liquid,"
discovered and described in 1831 by two chemists,
Soubeiran and Liebig, simultaneously but indepen-
105
SIR JAMES SIMPSON
dently. In 1835 its chemical composition was first
accurately ascertained by Dumas, the famous French
chemist. Simpson was apparently not aware that early
in 1847 ariother French chemist, Flourens, had drawn
attention to the effect of chloroform upon animals, or
he would probably have hastened to use it upon him-
self experimentally, instead of putting away the first
specimen obtained as unlikely ; it was heavy and not
volatile looking, and less attractive to him than other
substances. How it finally came to be tried is best
described in the words of Simpson's colleague and
neighbour, Professor Miller, who used to look in every
morning at nine o'clock to see how the enthusiasts
had fared in the experiments of the previous evening.
" Late one evening, it was the 4th of November,
1847, ^^^ returning home after a weary day's labour.
Dr. Simpson with his two friends and assistants, Drs.
Keith and Duncan, sat down to their somewhat
hazardous work in Dr. Simpson's dining-room.
Having inhaled several substances, but without much
effect, it occurred to Dr. Simpson to try a pon-
derous material which he had formerly set aside
on a lumber-table, and which on account of its
great weight he had hitherto regarded as of no
likelihood whatever ; that happened to be a small
bottle of chloroform. It was searched for and re-
covered from beneath a heap of waste paper. And
with each tumbler newly charged, the inhalers resumed
their vocation. Immediately an unwonted hilarity
106
THE DISCOVERY OF ANAESTHETICS
seized the party — they became brighteyed, very
happy, and very loquacious — expatiating on the
delicious aroma of the new fluid. The conversation
W2iS of unusual intelligence, and quite charmed the
listeners — some ladies of the family and a naval
officer, brother-in-law of Dr. Simpson. But suddenly
there was a talk of sounds being heard like those of a
cotton mill louder and louder ; a moment more and
then all was quiet — and then crash ! On awakening
Dr. Simpson's first perception was mental — " This is
far stronger and better than ether," said he to himself.
His second was to note that he was prostrate on the
floor, and that among the friends about him there was
both confusion and alarm. Hearing a noise he turned
round and saw Dr. Duncan beneath a chair — his jaw
dropped, his eyes staring, his head bent half under him ;
quite unconscious, and snoring in a most determined
and alarming manner. More noise still and much
motion. And then his eyes overtook Dr. Keith's feet
and legs making valorous attempts to overturn the
supper table, or more probably to annihilate everything
that was on it. By and by Dr. Simpson having
regained his seat. Dr. Duncan having finished his un-
comfortable and unrefreshing slumber, and Dr. Keith
having come to an arrangement with the table and its
contents, the sederunt was resumed. Each expressed
himself delighted with this new agent, and its inhala-
tion was repeated many times that night — one of the
ladies gallantly taking her place and turn at the
107
SIR JAMES SIMPSON
table — until the supply of chloroform was fairly
exhausted."
The lady was Miss Petrie, a niece of Mrs. Simpson's ;
she folded her arms across her breast as she inhaled the
vapour, and fell asleep crying, " I'm an angel ! Oh,
I'm an angel " ! The party sat discussing their
sensations, and the merits of the substance long
after it was finished ; they were unanimous in
considering that at last something had been found
to surpass ether.
The following morning a manufacturing chemist
was pressed into service, and had to burn the midnight
oil to meet Simpson's demand for the new substance.
So great was Simpson's midwifery practice that he was
able to make immediate trial of chloroform, and on
November loth' he read a paper to the Medico-
Chirurgical Society, describing the nature of his
agent, and narrating cases in which he had already
successfully used it. " I have never had the pleasure,"
he said, " of watching over a series of better and more
rapid recoveries ; nor once v/itnessed any disagreeable
results follow to either mother or child ; whilst I have
now seen an immense amount of maternal pain and
agony saved by its employment. And I most con-
scientiously believe that the proud mission of the
physician is distinctly twofold — namely to alleviate
human suffering as well as preserve human life."
In a postscript to the same paper he states on
November 15th that he had already administered
108
THE DISCOVERY OF ANiESTHETICS
chloroform to about fifty individuals without the
slightest bad result, and gives an account of the
first surgical cases in v^hich he gave the agent to
patients of his friends, Professor Miller and Dr.
Duncan, in the Edinburgh Royal Infirmary. " A
great collection," he says, " of professional gentle-
men and students witnessed the results, and amongst
them Professor Dumas, of Paris, the chemist who
first ascertained and established the chemical compo-
sition of chloroform. He happened to be passing
through Edinburgh, and was in no small degree
rejoiced to witness the v/onderful physiological
effects of a substance with whose chemical history
his own name was so intimately connected." Four
thousand copies of this paper were sold in a few
days, and m.any thousands afterwards.
It is worthy of mention that, according to a promise,
Professor Miller had sent for Simpson a few days after
the discovery to give chloroform to a patient on whom
he was about to perform a major operation ; Simpson,
however, was unavoidably prevented from attending,
and Miller began the operation without him — at the
first cut of the knife the patient fainted and died. It
is easy to imagine what a blow to Simpson, and to
the cause of anaesthesia this would have been had it
happened while the patient was under chloroform.
Thus in little more than a year from the date of
Morton's discovery of the powers of ether, Simpson
had crowned the achievement by the discovery of the
109
SIR JAMES SIMPSON
equally wonderful and beneficial powers of chloroform.
Already he had made two satisfactory answers to
the question he had early set himself — first, the appli-
cation of anaesthesia to midwifery practice ; and, second,
the discovery of the properties of the more portable
and manageable chloroform ; the third, and perhaps
the greatest, the defence of the practice, and the
beating down of the powerful opposition to anaesthesia
was yet required to render his reply complete.
IIO
CHAPTER VII
The Fight for Anesthesia. 1847 onwards
His faith in chloroform — Confused public opinion on the subject —
Personal attacks — Opposition on professional grounds — His reply —
Opposition on moral grounds — His reply — Opposition on religious
grounds — His reply — Her Majesty the Queen anaesthetised — Indis-
crete supporters — The Edinburgh teaching of anaesthesia adminis-
tration— The far-reaching effects of the successful introduction of
anaesthesia.
PROFESSOR SIMPSON firmly believed that
he possessed now in chloroform an anaesthetic
agent "more portable, more manageable and powerful,
more agreeable to inhale, and less exciting " than
ether, and one giving him " greater control and com-
mand over the superinduction of the anaesthetic state."
Fortified by this belief, full of facts relating to the
subject, and fired with zeal and enthusiasm, he was
prepared to meet the opposition which from his
knowledge of human nature he must have anticipated.
So bravely and so emphatically did he champion the
III
SIR JAMES SIMPSON
cause that he became identified with it in the public
mind. The revelation of anaesthesia, the discovery of
chloroform, and the application of anaesthetics to
surgery as w^ell as to midwifery were attributed to him
by all classes of the community, not even excepting
many of his own profession. Chloroform was spoken
of as if ether had never existed ; and chloroform and
chloroforming displaced the terms anaesthetic and
anaesthetising in ordinary talk — such unwieldy terms
were naturally abandoned when there was the excuse
that chloroform was universally considered the best
substance of its class. Simpson made no attempt as
Morton had done to patent his discovery under a
fanciful nam-e for his own pecuniary profit ; but
widely spread abroad every particle of knowledge con-
cerning it that he possessed, so that every practitioner
was forthv/ith enabled to avail himself thereof for the
benefit of his patients.
Partly owing to his own enthusiasm and his strong
belief in the superiority of chloroform over ether, and
partly owing to the confusion prevailing in general
circles as to the history of anaesthesia, no small number
of attacks were directed against Simpson personally
by those who either were jealous of his achievements,
or who considered that the part taken by themselves
or their friends in the estabHshment of this new era in
medical science had been sHghted or overlooked.
Simpson took all these as part of the fight into which
he had entered. His nature was not sensitive to
112
THE FIGHT FOR ANESTHESIA
such personal attacks ; he repHed to them, cast
them off, and went oji his way unaffected. He
handled some of these oppojients somewhat severely
when they accused him of encouraging the public
belief in him as the discoverer of anaesthesia. It
is clear to us to-day after anaesthesia has been on
its trial for fifty years that Simpson magnified the supe-
riority of chloroform over ether, and was led by that
feeling to look on the history of ether as but a stage
in the history of the greater chloroform. He regarded
chloroform as the onlv anaestlictic ; his utterances
betrayed this feeling, and offence was naturally taken
by the introducers and advocates of etlicr. His
opinioji of chloroform was shared by the leading
European surgeons to such an extent in his day that
shortly after his death Professor Gusserow, of Berlin,
stated that with a few exceptions almost all over the
earth nothing else was used to produce anaesthesia but
chloroform.
The real fight for anaesthesia was against those who
found in the practice something which ran contrary
to their beliefs or principles. There were first those
who objected on purely ?ned'tcal grounds ; secondly,
those who took exception to it from a ?noral
point of view ; and thirdly, those who found their
religious convictions seriously offended by the new
practice.
The medical opponents were, perhaps, the most
powerful ; certainly it was they who had first to be
113 1
SIR JAMES SIMPSON
won over, for without the support of the professioji
the cause was in danger. It was urged first of all that
the use of anaesthetics would increase the mortality,
then very great, of surgical operations, and those who
took their stand upon this ground were men who had
at first denied the possibility of making operations
painless, an.d had been driven to abandon that opinion
only by a clear demonstration of the fact. To meet
this form of opposition he instituted a laborious and
extensive statistical investigation in order to compare
the results obtained in hospitals where anaesthetics
were used with those where the operations were
performed on patients in the waking state. He took
care that the reports dealt with the same operations
under, as nearly as possible, similar conditions in each
case. He obtained returns from close upon fifty
hospitals in London, Edinburgh, Dublin, and various
provincial towns. One of the most fatal operations in
those days, and one dreaded by patient and surgeon
alike, was amputation of the thigh. In 1845 Pro-
fessor Syme said that the stern evidence of hospital
statistics showed that the average frequency of death
after that operation was not less than 60 to 70
per cent., or above one in every two operated upon.
Simpson fearlessly collated statistics of this operation
amongst the others, and proved that when performed
under anaesthetics amputation of the thigh had its
mortality reduced to 25 per cent. His figures were
as follows : —
114
THE FIGHT FOR ANAESTHESIA
Table of the Mortality of Amputations of the Thigh.
Reporter.
I Parisian hospitals — Malgaigne
Edinburgh ., — Peacock
jn J General collection — Phillips
Glasgow hospitals — Lawrie
British „ — Simpson
Cases on patients in an anaesthetised
state
No. of
Cases.
No. of
Deaths.
.. 20 I .
. 126 ..
.. 43 .
21 . .
.. 987 .
• 435 ••
.. 127 .
. 46 .'.
.. 284 .
. 107 ..
.. 145 .
. 37 ••
Percentage
of Deaths.
62 in 100
49 »
44 »
36 „
3S „
He pointed to the above table as a proof that far
from increasing the mortahty of this operation the
introduction of anaesthetics had already led to a saving
of from eleven to twenty lives out of every hundred
cases. He acknowledged that the number of cases he
had collected (145) was somewhat small from a statis-
tical point of view ; but he confidently asserted that
future figures would show greater triumphs. The
tables of other operations showed similar results,
and he entered exhaustively into the subject in
a paper published in 1848. The paper was en-
titled, " Does Anaesthesia increase or decrease the
mortality attendant upon surgical operations ? " Ac-
cording to his wont, he headed it with a quotation
from Shakspeare :
" Why doest thou whet thy knife so earnestly ?
. . . Shylock must be merciful.
On what compulsion must I ? Tell me that ! "
Victorious in this encounter, he turned to those who
115
SIR JAMES SIMPSON
urged that anaesthetics were responsible for various
kinds of ills such as a tendency to haemorrhage, con-
vulsions, paralysis, pneumonia, and various kinds of
inflammatory mischief as well as mental derange-
ment. He combated these contentions until the
end of his career ; and not only proved that the objec-
tions were visionary, but showed that for one of the
alleged evils formerly often seen after operations, viz.,
convulsions, chloroform, far from being a cause, was
one of our most powerful remedies.
But the professional opponents of anaesthesia were
most emphatic in the denunciation of its use in mid-
wifery. Pain in the process of parturition was, they
said, " a desirable, salutary, and conservative manifesta-
tion of life-force " : neither its violence nor its con-
tinuance was productive of injury to the constitution.
Strong opposition on these grounds came from the
Dublin School, and with characteristic boldness Simpson
turned to the statistics of their own lying-in hospital to
prove his contention that to abolish parturient pain
was to diminish the peril of the process. Again the
statistics stood him in good stead ; he flourished them
triumphantly before his opponents, and proceeded
to deal with those who asserted that the use of
anaesthetics was accompanied by danger to life. He
pointed out that, although unquestionably there were
some dangers connected therewith, they were insigni-
ficant compared with the dangers in both surgery and
midwifery which their use averted. Pain itself was a
ii6
THE FIGHT FOR ANESTHESIA
danger ; shock in surgery was responsible for many
untimely deaths upon the operating table ; by pre-
venting these chloroform saved countless lives. His
arguments were characterised by painstaking thorough-
ness and evidenced wide reading. In addressing
Professor Meigs, of Philadelphia, he said : —
" First, I do believe that if improperly and incau-
tiously given, and in some rare idiosyncrasies, ether
and chloroform may prove injurious or even fatal —
just as opium, calomel, and every other powerful
remedy and strong drug will occasionally do. Drink-
ing cold water itself will sometimes produce death.
* It is well known,' says Dr. Taylor, in his excellent
work on Medical Jurisprudence, * that there are many
cases on record in which cold water, swallowed in
large quantity and in an excited state of the system,
has led to the destruction of life.' Should we there-
fore never allay our thirst with cold water ? What
would the disciples of Father Mathew say to this ?
But, secondly, you and others have very unnecessary
and aggravated fears about the dangers of ether and
chloroform, and in the course of experience you will
find these fears to be, in a great measure, perfectly
ideal and imaginary. But the same fears have, in
the first instance, been conjured up against almost
all other innovations in medicine and in the common
luxuries of life. Cavendish, the secretary to Cardinal
Wolsey, tells us in his life of that prelate, that when
the cardinal was banished from London to York
117
SIR JAMES SIMPSON
by his master — that regal Robespierre, Henry the
Eighth — many of the cardinal's servants refused to go
such an enormous journey — 'for they were loath to
abandon their native country, their parents, wives, and
children.' The journey which can now be accomplished
in six hours was considered then a perfect banish-
ment. ... In his Life of Lord Loughborough, John
Lord Campbell tells us that when he (the biographer)
first travelled from Edinburgh to London in the mail-
coach the time had been reduced (from the former
twelve or fourteen days) to three nights and two days ;
' but,' he adds, ' this new and swift travelling from
the Scots to the English capital was wonderful, and I
was gravely advised to stop a day at York as several
passengers who had gone through without stopping
had died of apoplexy from the rapidity of the motion '
('Lives of the Lord Chancellors'). Be assured that
many of the cases of apoplexy, &c., &c., alleged to
arise from ether and chloroform, have as veritable an
etiology as this apoplexy from rapid locomotion, and
that a few years hence they will stand in the same
light in which we now look back upon the apoplexy
from travellinof ten miles an hour. And as to the
supposed great moral and physical evils and injuries
arising from the use of ether and chloroform, they will
by and by, I believe, sound much in the same way
as the supposed great moral and physical evils and
injuries arising from using hackney coaches, which
were seriously described by Taylor, the water-poet,
ii8
THE FIGHT FOR AN/ESTHESIA
two or three centuries ago when these coaches were
introduced. Taylor warned his fellow-creatures to
avoid them, otherwise ^ they would find their bodies
tossed, tumbled, rumbled, and jumbled ' without mercy.
' The coach,' says he, ' is a close hypocrite, for it hath
a cover for knavery ; they (the passengers) are carried
back to back in it like people surprised by pirates, and
moreover it maketh men imitate sea-crabs in being
drawn sideways, and altogether it is a dangerous
carriage for the commonwealth.' Then he proceeds
to call them 'hell-carts,' &c., and vents upon them a
great deal of other abuse very much of the same kind
and character as that lavished against anaesthetics in
our own day."
Following out the same line of reasoning he brought
to the minds of medical opponents how the introducers
of such useful drugs as mercury, antimony, and cinchona
bark had met with now long-forgotten but stubborn
opposition ; and he reminded surgeons of the stern
obstinacy with which the introduction of the ligature
of arteries had been long objected to and the barbarous
method of arresting bleeding with red-hot irons had
been preferred. But in the history of the discovery
and introduction of vaccination by Jenner he found a
strong parallel ; and he wrote a pregnant article to
prove that mere opinion and prejudgments were not
sufficient to settle the question of the propriety or
impropriety of anaesthetic agents, illustrating it from
the story of vaccination. The result of vaccina-
119
SIR JAMES SIMPSON
tion had been to save during the half century since its
introduction a number of lives in England alone equal
to the vi^hole existing population of Wales ; and in
Europe during the same period it had preserved a
number of lives greater than the v^hole existing
population of Great Britain. And yet Jenner, when
he first announced his discovery, had encountered the
most determined opposition on the part of many of
his professional brethren, w^ho ridiculed and bitterly
denounced both him and his discovery ; v^^hilst
ignorant laymen announced that small-pox was
ordained by heaven and vaccination was a daring and
profane violation of holy religion. He pointed out
that these objections had been slowly and surely
crushed out of existence by accumulated facts, and
predicted that the ultimate decision concerning anaes-
thesia would come to be based, not upon impressions,
opinions, and prejudices, but upon the evidence of " a
sufficient body of accurate and well-ascertained facts."
To these facts, as has been indicated, he subsequently
successfully appealed.
Those who objected to anaesthesia on moral grounds
directed their attacks chiefly against its use in mid-
wifery. They not only condemned that application
as iniquitous, but went the length of asserting that
the birth of past myriads without it proved how
unnecessary it was, and that Nature conducted the
whole process of birth unaided in a greatly superior
manner. The pains associated with parturition
120
THE FIGHT FOR ANESTHESIA
were actually beneficial, they said. Simpson answered
this by showing that the proper use of anaesthetics
shortened parturition, and by diminishing the amount
of pain led to more rapid and more perfect recoveries.
The leading exponent of the Dublin School of Mid-
wifery at that time foolishly wrote that he did not
think any one in Dublin had as yet used anaesthetics
in midwifery ; that the feeling was very strong against
its use in ordinary cases, merely to avert the ordinary
amount of pain, which the Almighty had seen fit —
and most wisely, no doubt — to allot to natural labour ;
and in this feeling he (the writer) most heartily con-
curred. Simpson's private comment on this remarkable
epistle at once showed his opinion of it, and ridiculed
the objection out of existence. He skilfully parodied
the letter thus : — "I do not believe that any one in
Dublin has as yet used a carriage in locomotion ; the
feeling is very strong against its use in ordinary pro-
gression, merely to avert the ordinary amount of
fatigue which the Almighty has seen fit — and most
wisely, no doubt — to allot to natural walking ; and in
this feeling I heartily and entirely concur."
He twitted the surgeons who opposed him with
their sudden discovery, now that anaesthetics were
introduced, that there was something really beneficial
in the pain and agony caused by their dreaded knife.
Such a contention contraverted his cherished principle
that the function of the medical man was not only to
prolong life, but also to alleviate human sufferings.
121
SIR JAMES SIMPSON
•He quoted authorities of all times to show that pain
had been always abhorred by physicians and surgeons,
commencing with a reference to Galen's aphorism —
^^ Dolor dolentibus inutile est'"' ("pain is useless to the
pained ") ; citing Ambroise Pare, who said that pain
ought to be assuaged because nothing so much de-
jected the powers of the patient ; and, finally, repro-
ducing the words of modern authors, who asserted
that, far from being conducive to well-being, pain
exhausted the principle of life, and in itself was fre-
quently both dangerous and destructive. He brought
forward a collection of cases where in former days
patients had died on the operating-table, even before
the surgeon had begun his work, so great was the
influence of the mere fear of pain ; and reminded those
who attributed occasional deaths on the operating-
table to the influence of the anaesthetic of the
numerous cases in bygone days where death occurred
whilst the surgeon was at work. He recalled also
how the great surgeon of St. Thomas's Hospital,
Cheselden, had-abhorred the pain which he caused in
the process of his work, and longed for some means
for its prevention. " No one," said Cheselden, " ever
endured more anxiety and sickness before an operation "
than himself.
Simpson did not forget to look at the subject from
the patient's point of view, and reproduced the letter
from an old patient, which has been already quoted
(Chapter VI.).
122
THE FIGHT FOR ANESTHESIA
The soldier and sailor, brave unto heroism in
facing the enemy, never fearing the death w^hich
stared them in the face in its most horrible form
whilst answering the call of duty, would quail like
children at the mere thought of submitting to the
deliberate knife of the surgeon. Were quibbles
about the efficacy of pain to stand in the way of the
merciful prevention of such suffering by the process of
anaesthetisation ?
Those who opposed him with this curious idea,
that pain after all was beneficial, were some of
them men of no mean standing in the profession.
Gull, Bransby Cooper, and Nunn were amongst those
whom he had to silence. After replying to their
arguments seriatim with all his polemic power, he
referred them once more to the evidence of facts
and of facts alone as set forth by his statistics. Had
he lived but a twelvemonth lonsrer than he did he
D
would have been able to conjure up a picture of the
incalculable amount of suffering prevented by the
eighteen hundred pounds of chloroform which were
forwarded to the rival armies from one firm of
chemists alone during the Franco-Prussian war ; happily
for the wounded within and around Paris, there was
then no longer any doubt as to the propriety of
employing anaesthetics.
The religious objections to the use of anaesthetics
could scarcely be m^et with statistics. Foolish as they
now appear to us after the lapse of time, and with the
123
SIR JAMES SIMPSON
practice they attempted to repel universally adopted,
they were nevertheless urged in good faith by clergy
and laity of various denominations. The same kind
of bigotry had met the introduction of vaccination,
and Simpson himself remembered how many people
had opposed the emancipation of the negroes on the
ground that they were the lineal descendants of Ham,
of whom it was said " a servant of servants shall he be
unto his brethren." Sir Walter Scott reminds us, in
" Old Mortality," of the spirit which met the intro-
duction of fanners to separate the chaff from the corn,
which displaced the ancient method of tossing the
corn in the air upon broad shovels. Headrigg re-
proved Lady Bellenden for allowing the new process to
be used on her farm, " thus impiously thwarting the
will of Divine 'Providence by raising a wind for your
leddyship's ain particular use by human art, instead of
soliciting it by prayer or waiting patiently for whatever
dispensation of wind Providence was pleased to send
upon the sheeling hill."
To-day in South Africa the same spirit is seen.
Honest countryfolk of European descent are earnestly
counselled by their spiritual advisers to submit patiently
to the plague of locusts on the ground that it comes
as a punishment from Providence. These worthy
men stolidly witness their cornfields and their grass
lands being eaten bare before their eyes in a few
hours, whilst their more enlightened neighbours,
brought up in another faith, resort with success to
124
\
\
THE FIGHT FOR ANAESTHESIA
all sorts of artifices to ward off the destructive little
invaders.
It is pleasant to be able to record that Dr. Chalmers,
one of the heroes of Scots religious history, not only
countenanced chloroform by witnessing operations
performed under it in the Royal Infirmary, but when
requested to deal in a magazine article with the
theological aspect of anaesthesia refused on the ground
that the question had no theological aspect, and advised
Simpson and his friends to take no heed of the "small
theologians " who advocated such views. This was
futile advice to give to one of Professor Simpson's
controversial propensities ; he entered with keen en-
joyment into the fray with these "religious" oppo-
nents. His famous pamphlet, entitled, " Answer to the
Religious Objections advanced against the employment
of Anaesthetic Agents in Midwifery and Surgery,"
fought his enemies with their own weapons by appeal-
ing with consummate skill to Scripture for authority
for the practice. The paper was headed with two
scriptural verses : — " For every creature of God is
good, and nothing to be refused if it be received with
thanksgiving" (i Timothy iv. 4). "Therefore to
him that knoweth to do good and doeth it not to him
it is sin " (James iv. 17).
The principal standpoint of the religious opponents
was the primeval curse upon womanhood to be found
in Genesis. Simpson swept the ground from under his
opponents' feet by reference to and study of the original
125
SIR JAMES SIMPSON
Hebrew text. The word translated — "sorrow" ("I
will greatly multiply thy sorrow ... in sorrow shalt
thou bring forth ") — was the same as that rendered as
"sorrow" in the curse applied to man ("in sorrow
shalt thou eat of it all the days of thy life "). Not
only did the Hebrew word thus translated sorrow
really mean labour, toil, or physical exertion ; but in
other parts of the Bible an entirely different Hebrew
word was used to express the actual pain incident to
parturition. The contention, then, that sorrow in
the curse meant pain was valueless. Chloroform re-
lieved the real pain not referred to in the curse,
whereas it had no effect upon the sorrow or physical
exertion.
If, however, the curse was to be taken literally in
its application to woman as these persons averred, and
granting for the moment that sorrow did mean
pain, their position was entirely illogical. If one part
of the curse was to be interpreted literally, so must be
the other parts, and this would have a serious effect of
a revolutionary nature upon man and the human race
all over the face of the earth. Literally speaking, the
curse condemned the farmer who pulled up his thorns
and thistles, as well as the man who used horses or
oxen, water-power, or steam-traction to perform the
work by which he earned his bread ; for was he not
thereby saving the sweat of his face ?
Pushed further, the same argument rendered these
contentions more absurd and untenable. Man was
126
THE FIGHT FOR ANtESTHESIA
condemned to die — " dust thou art and unto dust thou
shalt return." What right had the physician or
surgeon to use his skill to prolong life, at the same
time that he conscientiously abstained from the use
of anaesthetics on the ground that they obviated pain
sent by the Deity ? Nay, more ; sin itself was the
result of the Fall ; was not the Church herself
erroneously labouring to turn mankind from sin ?
In a truer and more serious religious spirit he
reminded his foolish opponents of the Christian dis-
pensation, and pointed out how the employment of
anaesthesia was in strict consonance with the glorious
spirit thereof.
Some persons broadly stated that the new process
was unnatural ; even these he condescended to
answer. " How unnatural," exclaimed an Irish lady,
"for you doctors in Edinburgh to take away the
pains of your patients." "How unnatural," said he,
" it is for you to have swam over from Ireland to
Scotland against wind and tide in a steam-boat."
A son of De Quincey in his graduation thesis
humorously supported Professor Simpson. He argued
that the unmarried woman who opposed anaesthetics
on the ground that her sex was condemned by the
curse to suffer pains, broke the command herself " in
four several ways, according to the following tabular
statement " : —
" I. She has no conception.
2. She brings forth no children.
127
SIR JAMES SIMPSON
3. Her desire is not to her husband.
4. The husband does not rule over her.'*
De Quincey himself supported his son in a letter
appended to the thesis thus : — " If pain when carried
to the stage which we call agony or intense struggle
amongst vital functions brings with it some danger
to hfe, then it will follow that knowingly to reject
a means of mitigating or wholly cancelling the danger
now that such means has been discovered and tested,
travels on the road towards suicide. It is even worse
than an ordinary m^ovement in that direction, because
it makes God an accomplice, through the Scriptures,
in this suicidal movement, nay, the primal instigator
to it, by means of a supposed curse interdicting the
use of any means whatever (though revealed by Him-
self) for annulling that curse."
But the Bible furnished Simpson with the most
powerful argument of all in Genesis ii. 21, where it is
written : " And the Lord God caused a deep sleep to
fall upon Adam ; and he slept ; and He took one of
his ribs and closed up the flesh instead thereof." He
strengthened his position by explaining that the word
rendered " deep sleep " might more correctly be
translated " coma " or " lethargy." He had taken
the full measure of his opponents when he answered
them with this quotation ; it was a reply characteristic
of the man, and completely defeated these self-con-
stituted theologians with their own weapons. They
had attacked him as a man of science, and found
128
THE FIGHT FOR ANESTHESIA
that his knowledge of the Scriptures excelled their own.
He did not fail to read these people a lesson, and point
out the harm done to true religion by such conduct
and arguments as theirs, reminding them that if God
had willed pain to be irremovable no possible device
of man could ever have removed it.
Such was the great fight — the fight for anaesthesia —
which Simpson fought and won. He was the one
man who by his own individual effort established the
practice of anaesthesia, while Morton has the honour
of being the one man without whom anaesthesia might
have remained unknown. Such was the opposition en-
countered, and such was the timidity of his professional
brethren, that but for Simpson's courageous efforts it
would have been the work of years to bring about what
it was granted to him to accomplish in a brief period ;
if fear, ridicule, contempt, and bigotry had not perhaps
sunk the new practice into oblivion. Of the hundreds
who are daily mercifully brought under the influence
of chloroform and ether, few are aware what they
owe to Simpson, even if they know how great is the
suffering which they are spared.
Simpson felt that the victory was indeed complete
when in April, 1853, he received a letter from Sir
James Clark, physician in ordinary to Her Majesty,
informing him that the Queen had been brought
under the influence of chloroform, and had expressed
herself as greatly pleased with the result. It was at
the birth of the late Prince Leopold that Her Majesty
set her subjects this judicious example.
129 K
SIR JAMES SIMPSON
Much trouble to the cause was occasioned by
enthusiasts who administered chloroform with more
zeal than discretion, and without any study of the
principles laid down by Simpson. As a result of
imperfect trials, some persons went the length of
saying that there were people v/hom it was impossible
to anaesthetise at all, and others who could be only
partially anaesthetised. Wrong methods of adminis-
tration were used. Simpson patiently corrected these,
and carefully instructed his students, so that the young
graduates of Edinburgh University carried his teaching
and practice into all parts of the world. Syme also
took up the cause, and valuable work was done in
London by Snow, and later by Clover. The teaching
of Simpson and Syme led to such successful results
that their methods are followed by the Edinburgh
School to this day practically unaltered. So satis-
factory an agent is chloroform in Edinburgh hands,
that other anaesthetics are in that city but rarely called
into requisition. All the world over it is the anaes-
thetic in which the general practitioner places his
trust.
Having seen what Simpson did for anaesthesia, we
may briefly review what anaesthesia has done for
humanity. That it has entirely abolished the pain
attendant upon surgery is easily recognised by the
profession and patients alike. The patient never begs
for mercy nowadays ; he dreads the anaesthetic more
than the knife ; he has no anxiety as to whether he
130
THE FIGHT FOR ANESTHESIA
will feel pain or not, but rather as to whether he will
come round when the operation is over ; happily
after one experience he realises that his fears were
unfounded, and, if need be, will submit cheerfully
to a second administration.
The horrors of the operating-room referred to in
the preceding chapter were vanquished with the pafn ;
the surgeon has no longer to steel himself for the
task as formerly, to wear a stern aspect and adopt a
harsh manner. The patient has no longer to be held
down by assistants ; instead of having to be dragged
unwillingly to the operating-table — a daily occurrence
sickening to the hearts of fellow-patients and students,
while it served only to harden the surgeon and the
experienced old nurse of those days — he will walk
quietly to the room, or submit patiently to be carried
there, and at a word from the surgeon prepare
" . , . .to storm
The thick, sweet mystery of chloroform,
The drunken dark, the little death-in-life."
The operation is no longer a race against time ;
order, method, cleanliness, and silence prevail, where
there was formerly disorder, bustle, confusion, dirt,
and long-drawn shrieks. Nothing illustrates better
the progress of surgery than a picture of the operating
room in the first decade placed beside that of an
operating theatre in one of our leading hospitals in
this the last decade of the nineteenth century. In
the quiet of the patient, in the painlessness of the
SIR JAMES SIMPSON
operation, in the calm deliberation of the operator,
and the methodical order of all around him, in the
respectful silence that prevails in the room so soon
as the patient is laid on the table, we see the direct
results of the introduction of anaesthetics. But there
are other great, if less direct, results, each making its
presence known to the professional spectator. By
anaesthesia successful operations previously unheard of
and unthought of were made possible after the
principle of antiseptic surgery had been established ; by
anaesthesia experimental research, which has led to
numerous beneficent results in practical surgery and
medicine, was made possible. Its introduction is an
achievement of which the Anglo-Saxon race may well
be proud. Wells, Morton, and Simpson are its heroes.
The United States has by far the greater share of the
honour of its discovery ; but to Scotland is due the
glory which comes from the victorious fight. No
event in surgery up to 1847 ^^^ ^^^ ^'^^^ far-reaching
effects. Simpson himself looked forward to the dis-
covery of some agent, better than both chloroform
and ether ; and it is still possible that there may be an
even greater future in store for anaesthesia than was
ever dreamt of in his philosophy.
132
CHAPTER VIII
Home Life — Controversies
The foundations of his fame ; Comparison with Boerhaave — Family
letters — Home amusements — Affection for children — And for
animals — Puck — Holidays — Wide area of practice — "The arrows
of malignancy " — Squabbles — Homoeopathy — Mesmerism — Refuses
to leave Edinburgh.
GREAT as was Simpson's contemporary fame,
the chief part of it had its origin in his
indescribable personal power over his fellows, and in
his inexhaustible energy. When to these was added
the reputation won by the discovery of chloroform's
anaesthetic properties, he stood not only as the most
famous physician of his day, but also as a man marked
out for posthumous fame. The personal character-
istics of the man were speedily forgotten after his
death, save by those who had been brought under
their influence ; the marked prominence given to
Simpson and the " discovery of chloroform " in the
numerous recent reviews of Queen Victoria's reign on
the occasion of the Diamond Jubilee, indicates that it
SIR JAMES SIMPSON
is by chloroform that Simpson will ever be re-
membered. His lasting reputation depends on this
work, not upon the characteristics which made him
famous in the judgment of his contemporaries. The
only physician in comparatively modern times, whose
reputation approached Simpson's in magnitude was
Hermann Boerhaave (1668 to 1738), the Dutch
physician, whose fame and influence during his
own lifetime were immense. Boerhaave's leading
characteristics greatly resembled Simpson's : he had
an enormous capacity for acquiring information,
and a wonderful facility for imparting instruction to
others ; his energy and industry were indefatigable,
and his memory prodigious. He taught from separate
Chairs in Ley den the Theory of Medicine, the Practice
of Medicine, Botany, Chemistry, and Clinical Medicine,
and at the same time carried on his large practice.
Patients of both sexes flocked to him from, all quarters
of the globe, and he is said to have accumulated from
his practice a fortune of ^200,000 in five and thirty
years. Although his treatment and method were,
according to our modern knowledge, unscientific,
his success in practice was as great as Simpson's ; it
sprang from the same cause ; a wonderful magnetic
personal influence, which commanded confidence and
faith, so that he succeeded with the same possibly quite
simple means which were fruitless in the hands of
others. In his day all Europe rang with Boerhaave's
name. To-day he is practically unknown. His books
^34
HOME LIFE
are antiquated, and if known, are neglected by-
modern physicians. He achieved nothing of lasting
benefit to humanity. His fate, at least so far as the
public is concerned, would undoubtedly have been
Simpson's, in spite of his obstetric and gynaeco-
logical work, had it not been for the discovery of
chloroform.
The increased fame and greatly increased pro-
fessional income which followed the successful struggle
for anaesthesia did not affect Simpson's homely
characteristics. He found time in the midst of it
all to enjoy the pleasures of home in the society of
those he loved best, and of intimate friends. He
took a keen delight in quite the smallest enjoy-
ments of the home circle. A characteristic letter was
written to his wife in the summer of 1849 5 ^^e had
gone with the children to the Isle of Man ; he told
her the great and small events of his daily life : —
" Delighted to hear from you that all were so well.
Everything goes on nicely here. I have been looking
out for a headache (but keep excellently well), for I
have been working very busily, and scarcely with
enough of sleep. Yesterday beat (as Clark writes it)
any day I ever yet saw in the house. Did not get out
till half-past four, and the drawing-room actually filled
beyond the number of chairs and seats ! Have had a
capital sleep, and got up to look at the ducks; but
none laying this morning, so I write instead. To-day
I have a fancy to run out to Bathgate, and I think I
SIR JAMES SIMPSON
will. . . . Yesterday dined with Miller, and Williamson,
the Duke of Buccleuch's huntsman, enlightened us
about dogs. Miller and I go to Hamilton Palace on
Saturday. . . . My ducks won't lay any more eggs,
at which I feel very chagrined. . . . Two salmon
came as presents last week. 1 gave one to Mrs.
Bennet. We are beginning a new batch of exam-
inations at the college. Such a sleep as I had yesterday
morning ! I came home by the last Glasgow train,
very tired. Tom came to waken me at eight, but I
snored so that he didn't. He called me at half-past
nine. I don't think I had stirred from the moment I
lay down. This morning I have been reading in bed
since six. I did not rise till now (half-past seven),
because there was no duck laying."
In another letter written on the same occasion he
says : —
" . . . . Tell Davie I expect a letter from him.
Say to Walter that yesterday Carlo jumped into the
carriage after me and saw with me several patients.
He usually mounted a chair at the side of each bed
and looked in. But Mrs. S. gave him too much
encouragement. He leaped into bed altogether and
tramped upon a blister ! which was very painful."
It was his custom to keep open house at breakfast
and luncheon time ; but the evening meal was, as a
rule, reserved so that he might see and enjoy his own
family and intimates. He lived exceedingly plainly
himself; he did not smoke; his drink was water:
136
HOME LIFE
but he delighted in setting a goodly repast before his
guests. He loved a romp with his children, and
spared an occasional hour from the afternoon for that
enjoyment. The same energy entered into his play
that was seen in his work. A craze ran through
fashionable circles in the fifties for tableaux vivants,
and was taken up by the Simpson household. He
entered with spirit into the new amusement, perhaps
more keenly because he saw an opportunity of com-
bining in such representations instruction with amuse-
ment. Historical personages and scenes were repre-
sented, as well as illustrations of poetry and fiction.
With his infective enthusiasm he pressed poets and
painters, grave and gay, into service, and there is a
record of one highly successful entertainment at 52,
Queen Street, in 1854, ^^ which young and old alike
were invited. On this occasion most of the scenes
represented serious events in Scots history, but Simp-
son himself seems to have supplied a little comedy.
Sandwiched between a scene of " Flora Macdonald
watching Prince Charlie " and one of " Rebecca and
Eleazar at the Well " came that of " The Babes in
the Wood." Simpson and a professional colleague
disported themselves as the Babes, and appeared suck-
ing oranges and dressed as children — short dresses,
pinafores, frilled drawers, white socks, and children's
shoes. They wandered about a while, and then lay
weeping down to die to an accompaniment of roars of
laughter and to the great delight of the juveniles. It
SIR JAMES SIMPSON
is but a small incident to chronicle, but it shows in his
home life the great physician who was beloved by
thousands. His deep sympathies made him delight
in the society of children. As years increased, and
with them work became overwhelming and worries
and troubles persistent, he appreciated more and more
the refreshment of a frolic with his children. He
echoed Longfellow's pure words : —
" Come to me, oh ye children,
For I hear you at your play,
And the questions that perplexed me
Have vanished quite away.
For what are all our contrivings,
And the wisdom of our books,
When compared with your caresses
And the gladness of your looks."
His afFectionafe disposition and kindly manner gained
the devotion of his many child patients ; and his own
family bereavements made him a sympathetic physician
and friend to many a sorrowing mother. There was
no cant or affectation in his sympathy ; it grew out of
his large heart.
Animals also he was fond of and gentle to, as we
know from the history of the dogs who successively
reigned in the household, so charmingly given to us
by his daughter. One episode in the life of Puck, a
black and tan terrier more intelligent than " breedy,"
deserves repetition. The dog had accompanied the
Professor and some of his children into the country
one afternoon on an expedition to dig for antiquarian
138
HOME LIFE
relics. " After tea Puck, seeing every one carrying
something to the station, demanded the honour of
relieving his master of a Lancet^ and went off with
his small burden looking very important. ... At the
station the dog was missing. All got into their places
but Puck. 'I will follow in the next train,' said
the Professor ; ' Puck is too dear a little friend to
lose. . . .' All he found of Puck was a muddy
Lancet^ and the last that had been seen of the old dog
was that he was pushing his way through a crowd of
idle colliers, where it was supposed his energies had
been so engrossed in guarding the Lancet that he had
lost sight of his party. . . . His master stayed there
until next morning, and some remembered afterwards
how Puck's loss gave them another evening's talk with
one they loved, though he broke in on the reminis-
cences with 'I wonder where little Puck is,' or 'Is
that his barkr" No Puck came to demand entrance,
and hope of his return was given up after three days
passing without news of him. His master was think-
ing of the sorrowful letter he would have to write to
Puck's companions when late one night, as he paced
wearily up and down the room, he thought he heard a
faint bark. There had been a great deal of listening
of late for the little dog's bark ; but it seemed vain to
think of Puck's retracing his steps through an un-
known country for so many miles. Still the Professor
opened the door and called. Up the area steps some-
thing did limp into the hall. That it was Puck
139
SIR JAMES SIMPSON
seemed doubtful at first, for he was quick and bright,
and this animal was a lame ball of mud hardly able
to crawl. The bright eyes, however, were Puck's ;
and he confirmed his identity by exerting his remain-
ing energies to give one leap gratefully to kiss the
friendly face that bent over him. . . . His truant play-
fellows received a long letter from their father telling
them of Puck's adventure and imagining Puck's feel-
ings and trials through his long wanderings. . . .
That letter always recalls Puck and his never-resting
master bending over his desk, despite press of business,
to send the news to Puck's companions."
Simpson looked no further than his own nursery
and circle of close friends for the refreshment and
recreation which nature demanded in the course of
his busy daily life. But holidays were necessary
sometimes. He exhibited all the aversion of an
enthusiastically busy man to leaving his work, but
would yield sometimes to the solicitations of fri'=;nds
and would more readily leave his patients for a
time if a prospect was held out of some interesting
archaeological research to be indulged in. In 1850 he
suffered from an abscess, caused by blood-poisoning
contracted during professional work. At the request
of his friends Professor Syme was called in, somewhat
to the chagrin of Simpson's old friend and colleague.
Miller. It is interesting to note that in spite of the
recent controversy on anaesthetics, Montgomery of
Dublin, who had keenly opposed him, was amongst
140
HOME LIFE
the first to write a sympathetic note on hearing of his
illness ; although dissenting from some of Simpson's
professional utterances, Montgomery was influenced
by the Professor's personality to respect him as a man
and a worker.
After this illness Simpson took a rapid run round
the Continent, visiting those cities where anything
professional was to be picked up. As he expressed
it himself he " scampered " round the Universities,
Museums, and Hospitals, seeing and hearing all that
was to be seen and heard. He stowed away the
newly acquired knowledge in the recesses of his
mighty brain, and hastened on to the next place of
interest before his companions had gained their breath
sufficiently to regard with intelligent interest the
objects he had already left behind. In Paris, on
the occasion of one of his flying visits into a
hospital, he w^as present at an operation, unknown
to the surgeon, in which chloroform was used not
only as a preventive ot pain, but also for its remedial
effect ; after the operation the surgeon addressed
his students upon the subject of chloroform, and
Simpson had the pleasure of listening to a hearty
eulogy of it. When, at the end, he handed in his
card, the operator's delight was genuine and effusive,
and the students enthusiastically appreciated the some-
what dramatic scene. On such occasions when he
had to submit to the embraces of delighted foreign
scientists, the exuberant manner in which they kissed
141
SIR JAMES SIMPSON
him was not to his liking ; even the remote strain of
French blood in his own veins did not help him to
enjoy the Continental mode of salutation. All over
Europe his name was honoured and revered. It is
said that when in later years an Edinburgh citizen
was presented at the Court of Denmark the King
remarked, " You come from Edinburgh ? Ah ! Sir
Simpson was of Edinburgh ! "
The last trip to the Continent, indeed his last real
holiday, was taken in 1868, when he ran over to
Rome. So public was the life he led, such matters
of interest to his fellow-countrymen were his comings
and goings, that the Scots?na?i newspaper chronicled
his doings, relating the sights and places of interest
which he visited, and noting that his professional
services were 'taken advantage of by many Roman
citizens during the few days that he was there ; and
that if time had permitted a public reception would
have been given to him. In all his foreign trips his
object was to learn, not to teach ; he followed Sir
Isaac Newton's advice to Ashton, and let his discourse
be more in queries than in assertions or disputings.
He took care neither to seem much wiser nor much
more ignorant than his company.
Sometimes feeling the need of rest himself he would
take one or perhaps three days for a rapid run to the
Lakes, or would spend another in the country unearth-
ing some antiquarian object. It was always a pleasure
to him to visit Bathgate, where his uncle and friend
142
HOME LIFE
Alexander had latterly resigned the baker's business and
taken up the role of banker. One of his favourite resorts
was a small house called Viewbank which he had taken,
situated on the shores of the Firth of Forth. Here
he was close to the fishing village of Newhaven ; the
fisher folks — the men and the picturesquely attired
" fish-wives " — a sturdy and original set of people,
were a great interest to him. They knew him
well both as an occasional visitor and as the good
physician.
One of his letters written in 1856 gives an indication
of the wide area over which his services were requisi-
tioned and rendered.
" Sunday.
" I write this at Viewbank, which is very pretty
this afternoon, but where I have not been for a week
or more. This year I have not yet had one single
holiday, and scarcely expect one now. I have had
many long runs during the past few months. I have
been often up in England, professionally, during the
summer ; once as far as Brighton seeing a consumptive
case ; once at Scarboro' where my wife went with
me ; once or twice in London where I saw the
Queen ; once at Ambleside. I long and weary for
3. real ]a.unt without a sick patient lying at the end of
it. And I had a great fancy to run from Manchester
to Douglas and send all the patients far enough ; I
have been too hard worked to write, but I must write
one or two papers now. Queen Street has been a
H3
SIR JAMES SIMPSON
little hotel during the summer — always some sick
lady or another sleeping in it, sometimes several at
night."
Even on these professional journeys he found time
to examine objects of interest in the neighbourhood ;
or if he was unable to leave the immediate proximity
of his patient, he brought pen and paper to the
bedside and worked while he waited ; thus he
economised time as he advised his students always
to do. It is doubtful if any one less great than
Simpson would have ever been allowed to labour thus
by a sufferer's bedside ; indeed even he was not always
permitted to do so. It is recorded that, at least, one
lady rose hastily and seized his pen so that he was
obliged to desist.
The striking form with which Nature had endowed
him, became more remarkable when affected by years,
work, and domestic afflictions. Though of medium
height his presence, even beside typically large-built
and large-boned fellow-countrymen, was never in-
significant. His features, overhung by his massive
forehead, surrounded by the long and thick hair,
spoke his character. Firm, concentrated mouth
and piercing eyes, when his mind was fixed on a
scientific or practical object. A soft, womanly tender-
ness about the lips, and a genial, sympathetic emotion
in his deep-set eyes when aroused by an object of pity
or pleasure. His hand was " broad and powerful, but
the fingers were pointed and specially sensitive of
144
HOME LIFE
touch." To see him was to see one of the sights of
the modern Athens. His features are famihar to us
to-day as one of the ring of briUiant, intellectual faces
forming a frame to the picture of Queen Victoria
in this the year of her Diamond Jubilee — a year of
triumphant retrospection, unprecedented in the history
of nations.
It was impossible that a man holding Simpson's
position, engaged in his work, and possessed of
distinct fighting characteristics, should not make
enemies. He could say, as Jenner said before him,
" As for fame, what is it ? A gilded butt for ever
pierced by the arrows of malignancy. The name
of John Hunter stamps this observation with the
signature of truth."
The arrows of malignancy did not hurt Simpson.
He was very little, if at all, affected by them ; but he
paid, perhaps, more attention to them than we might
have expected him to pay ; certainly more than they
deserved. His love of the fray led him oftentimes
to answer what had better have been left unnoticed,
and dragged him into prolonged, sometimes bitter, and,
it is to be regretted, often unworthy, controversies.
There was so much valuable work to be done, and
his efforts were always so fruitful in result that we
grudge the time spent in these squabbles ; there arises
an instinctive feeling that had he devoted the energy
wasted in these contests to furthering some single
branch of science, he would have made distinct
145 ^
SIR JAMES SIMPSON
advances therein. There was nothing superficial
about his work ; whatever the object it was tho-
roughly entered into ; his writings convey to one a
sense of the power he had of seeing all round and
through a question, and of weighing and judging
evidence. There was likewise no scamping in his
mode of treating his opponents in these squabbles ;
he used his weapons fearlessly and administered m.any
a trouncing to weak opponents.
It was a time of upheaval in things medical. The
microscope and stethoscope had been introduced into
the science and practice of the healing art. Scientific
experiment and research were beginning to lay the
foundations of rational medicine and surgery. Edin-
burgh was in the front rank of modern progress, as
she has ever 'been. Men like Simpson, Syme, Miller,
Alison, and Christison, were not likely to lag behind.
But, unfortunately, it was equally unlikely that such
great minds could all think alike in matters concern-
ing the principles of the science and art which they
taught and practised. Thus it happened that the
Edinburgh School became notorious for its internal
quarrels, and in these Simpson was, as a rule, to be
found busy.
Quite apart from these professional differences were
the disputes arising from attacks made upon Simpson
by professional brethren and laymen, who accused
him of wrong treatment or neglect of patients. His
fame endowed him with almost superhuman powers
146
HOME LIFE
in the minds of patients and their friends. When all
other means had failed Simpson was hastened to as
a last but sure resource ; bitter the disappointment,
bitter was the grief, and also sometimes bitter the
things said of him when the anxious friends of a
sufferer found that even Simpson's powers of healing
were limited. These attacks were some of the
" arrows of malignancy," which naturally fell about
the over-busy man. He thought it necessary to stop,
pick up these arrows, and challenge the assailants ;
we may regret that he stooped so often to this action,
but v/e feel that it sprang as much from the love of
truth and justice as from the dictates of a disposition
inclined towards quarrel.
It is impossible to pass over the great controversy
which raged in Edinburgh about 1850 on the merits
of homoeopathy, in which Simpson, of course, took a
leading part. About the beginning of the century
the practice of medicine by the apothecaries, as the
general practitioners were then called, consisted in
the most unscientific, nay, haphazard administration
of drugs in large quantities and combinations. It
was an age of drugging doctors, and the custom had
become so thoroughly established that it is doubtful
whether any less completely opposite system than that
introduced by Hahnemann would have convinced the
public that after all so many drugs were not required,
nor such large quantities of them. Homoeopathic
practice was founded on facts improperly interpreted,
147
SIR JAMES SIMPSON
and laid down for general use a procedure that was
applicable in only a limited number of cases. As Dr.
Lauder Brunton has recently pointed out, it is in many
instances only a method of faith-cure, and as such has
its value. The success which its practitioners cer-
tainly obtained in many cases where the ordinary
wholesale drugging of the day had proved futile, at
once made men pause ere allowing their bodies to
be made receptacles for the complicated preparations
of the physician. In Edinburgh at this time the
influence of homoeopathy had been felt. Alison, a
physician of great renown, was to the end a pro-
nounced polypharmacist, and was said scarcely ever
to leave a patient without a new bottle or prescrip-
tion. Graham, another university professor, was also
a thorough-going old school therapeutist. On the
other hand, Syme treated all medicine except rhubarb
and soda with disdain ; and Henderson, the professor
of Pathology, and also a practising physician, after
professing to consider no medicine of very much value,
became a pronounced sceptic, and finally horrified his
colleagues by making trials of homoeopathy, and
gradually becoming enamoured of it until he con-
fessed himself a full follower of Hahnemann's doc-
trines. Christison was leading the school which
urged that the action of medicines should be studied
experimentally if their administration was to be
founded on scientific grounds. The behaviour of
Henderson, who so greatly owed his position as pro-
148
HOME LIFE
essor to Simpson, stirred the wrath of the latter. He
examined and condemned the irrational system of
Hahnemann, and threw himself into an attitude of
strong opposition. Syme and Christison ably seconded
him in strong public action. Henderson was obliged
to resign his chair owing to " loss of health." Homoeo-
pathy was thoroughly crushed in Edinburgh. The
contest between the old system of drugging with large
complicated doses of powerful remedies, and the new
one of giving on principle infinitesimal doses of the
same medicines, served a good purpose. It gave an
opportunity for establishing rational therapeutics, a
science which is making daily progress, and in the
presence of which neither the old system nor homoeo-
pathy can stand.
About this same period mesmerism was again
coming to the front, this time cloaked as a science
termed electro-biology. Simpson acknowledged that
there was a great deal in mesmerism demanding
scientific investigation ; but with his reasoning powers
he could not realise the existence of the mystically-
termed higher phenomena of animal magnetism, e.g.^
lucidity, transference of the senses, and, above all,
clairvoyance. It happened that a professional mes-
merist gave a performance in Edinburgh ; learning
that the " professor's " daughter was stated to be able
to read anything written on paper, or to divine
any object enclosed in a sealed box while under her
father's mesmeric power, Simpson attended the per-
149
SIR JAMES SIMPSON
formance. He took with him a specially-prepared
test — a sealed box with certain unknown contents ;
this he presented at a suitable opportunity. Against
their own wishes, but on the insistence of the audi-
ence, the performers made an attempt by their
methods to detect the nature of the contents of this
test-box. They pronounced it to be money ; on
opening it millet seed was found, and a piece of
paper, on which was written, " humbug."
An accusation, couched in bitter terms, that Simpson
was really a supporter of mesmerism as it was then
known, was published in one of the leading profes-
sional journals in London. He indignantly repudiated
the suggestion and proposed to settle the matter
finally by a simple expedient. He offered to place five
sealed boxes each containing a line from Shakspeare
written by himself on paper, in the hands of the editor
of the journal who had permitted the attack to appear
in his columns. To any clairvoyant who read these
lines according to the professed method, and to the
satisfaction of a committee of eminent medical men,
he promised the sum of five hundred pounds. The
offer, however, was not accepted.
The brilliant attainments of many of its teachers at
this period not only placed the Edinburgh school at
the head of the British schools of medicine, but
also led to tempting offers being made to individual
professors by rival schools anxious to secure their
services.
150
HOME LIFE
London was a much more lucrative field for prac-
tice than the Scots metropolis, and several of the most
eminent Edinburgh men had from time to time
yielded to the temptation to migrate southwards. In-
deed, London as a medical school owes a great deal to
the Scotsmen whom she imported. Liston had left
for London in 1834, and Syme followed, for a brief
period, on Liston's death. In 1848 a strong effort was
made to secure Simpson as a lecturer on midwifery at
St. Bartholomew's Hospital ; without any hesitation
he decided to remain in the city where he had fought
his way to fame, and where he enjoyed popularity,
and a practice sufficiently lucrative to satisfy the most
ambitious man. Every patriotic Scot applauded the
decision.
During these years of fame and prosperity Simpson
concerned himself in schemes for the improvement of
the surroundings of the working classes, and helped
with speech and purse those who worked among the
poor. He strongly supported the establishment of
improved dwellings for workpeople^ and gave much
attention to the subject of Cottage Hospitals. He did
not neglect the poor amongst whom he had laboured
in his early days. He loved old Edinburgh, and the
poor inhabitants of it were near his heart. "The
Professor " v/as known in many a ",wynd" and "stair,"
where his services were rendered willingly and without
reward.
151
CHAPTER IX
Archaeology — Practice
His versatility — The Lyciiim of the Muses — The Cat-stane — Was the
Roman Army provided with medical officers ? — Weems — His lack
of business method — Fees and no fees — Generosity often imposed
upon — His unusual method of conducting private practice — The
ten-pound note — Simpson and the hotel proprietors.
PROFESSOR SIMPSON'S versatility was re-
markable. He turned from one subject to
another and displayed a mastery over each ; it was
not merely the knowledge of principles which aston-
ished but the intimate familiarity with details. He
was able to discuss almost any subject in literature,
science, politics, or theology with its leading exponent
on equal terms. He had the power of patient listen-
ing as well as the gift of speech ; more than that he
had the ability to charm speech from others, of making
each man reveal his inmost thoughts, betray his most
cherished theories, or narrate his most stirring ex-
periences ; the most reticent man would not realise
152
ARCHi¥.OLOGY— PRACTICE
until he had left Simpson's presence, that in a brief
interview, perhaps the first, he had told his greatest
adventures, or laid bare his wildest aspirations before
this student of mankind who was summarising his
life and character as he spoke. Simpson built up
his knowledge not so much from books as by the
exercise of his highly developed faculty of observation
aided by his memory. He enjoyed the study of his
fellow -men and extracted all that was worth knowing
from those with whom he came into contact. He
never undertook work without a definite object in
view, and rarely abandoned his task before that object
was accomplished. Quite small researches would lead
to considerable and unexpected labour. He preserved
his scientific method, his desire to appeal only to the
evidence of facts — not to other men's fancies — through
his archaeological work as well as in more professional
lines of study. He laboured long and carefully over
such an object as the study of old skulls dug up in
antiquarian excursions ; setting before himself the
object of finding out by the condition and wear of the
teeth what kind of food had been consumed by the
owners, probably primeval inhabitants of some district.
He impressed his methods upon those who worked for
him or with him. We find him writing to his
nephev/, who was about to visit Egypt, telling him
when there to gather information as to the suitability
of the country for invalids, and directing him how to
employ his leisure in furthering this object. He was
SIR JAMES SIMPSON
to study German on the voyage thither, and to take
with him as models Clarke's book on CHmate and
Mitchell's on Algiers, and any French or German
books on the subject he might hear of. He would
require to collect ( i ) The average daily temperature ;
(2) The hygrometric and barometric states daily ; (3)
The temperature of the Nile ; (4) The temperature
of any mineral springs ; (5) The general character of
the geology ; (6) The general character of the botany
of the country. He asked him to inquire specially as
to the effect of the climate on consumption, and
pointed out that Pliny described Egypt seventeen
centuries ago as the best climate for phthisical patients.
For amusement he was to take some good general
book on Egypt and Egyptian hieroglyphics. The
serious study of a succession of inquirers was to be
the young man's holiday amusement !
Simpson's most notable contributions to archaeology
were made when his time was most occupied profes-
sionally. The researches on Leprosy were first enlarged
and improved. In 1852, when in the British Museum,
his eye was attracted by a small leaden vase bearing
a Greek inscription signifying the Lycium of the
Muses, By a painstaking inquiry he established that
this lycium was the Lykion indikoii of Dioscorides, a
drug used by ancient Greeks as an application to the
eyes in various kinds of ophthalmia. It was obtained
from India, and is still used for these purposes in that
country. He discovered that there were three other
ARCHiEOLOGY— PRACTICE
examples of this ancient receptable for the valued eye-
medicine in modern museums.
He had correspondents in different parts of Scotland
engaged in making researches into antiquities, which
he encouraged and directed. Among such were in-
quiries into the whereabouts of a church said to
possess holy earth brought from Rome ; and a hunt
for ancient cupping-vessels. The work on the Cat-
stane of Kirkliston was elaborate, and a perfect example
of his method. Probably this stone, a massive un-
hewn block of greenstone-trap, had been a familiar
object to him in his youth, for it lay alone in a field
close to the Linlithgow road. In his monograph he
endeavoured to show by close reasoning, with pro-
fuse references to forgotten authorities and ancient
history, that the stone was the tomb of one Vetta, the
grandfather of Hengist and Horsa. His argument
ran as follows : The surname Vetta, which figured on
the inscription carved upon the stone, was the name of
the grandfather of Hengist and Horsa, as given by the
oldest genealogists, who described him as the son of
Victa. The inscription ran thus : VETTA F(ilius)
VICTI. Vetta was an uncommon Saxon name, and
no other Vetta, son of Victa, was known in history.
Two generations before Hengist and Horsa arrived in
England a Saxon host was leagued with the Picts,
Scots, and Attacots in fighting a Roman army, and
these Saxons were probably commanded by an ancestor
of Hengist and Horsa. The battlefield was situated
SIR JAMES SIMPSON
between the two Roman walls, and consequently
included the tract where the stone is now placed.
The palaeographic characters of the inscription indicated
that it was carved about the end of the fourth century.
Latin (with a very few exceptions in Greek) was the
only language known to have been used at that time
by Romanised Britons and foreign conquerors for the
purpose of inscriptions. The occasional erection of
monuments to Saxon leaders is proved by the fact
mentioned by Bede that in his time, the eighth
century, there stood in Kent a monument com-
memorating the death of Horsa. In 1659 a writer
had described this tomb of Horsa as havins; been
destroyed by "storms and tempests under the con-
duct of time."
In 1 86 1 Simpson was president of the Society of
Antiquaries of Scotland, and delivered an address on
the past and present work of archaeology v/hich greatly
stimulated antiquarian study in his country. Amongst
the honours which his antiquarian achievements brought
upon him was that of being appointed Professor of
Antiquities to the Royal Academy of Scotland ; he
was also elected a member of the Archaeological
Societies of Athens, Nassau, and Copenhagen.
He make researches into the subjects of lake
dwellings, primeval pottery, and burial urns. One
of his most valuable writings was upon the subject,
" Was the Roman Army provided with Medical
Officers ? " He answered the question in the affirma-
.56
ARCHAEOLOGY— PRACTICE
tive after a laborious hunt amongst votive and mortuary-
tablets ; no Roman historians had left clear indications
of the existence of any army medical department. He
found that several tablets were preserved bearing
inscriptions referring to army surgeons, which
suggested that although they were all known as
fnedicus there were degrees of rank amongst them,
notably the medlcus legionis and the rnedicus cohortis.
There is a well-preserved tablet in the Newcastle
Museum found in that neighbourhood, commemo-
rating a surgeon of the first Tungrian cohort, and
one in Dresden, referring to a inedicus dupUcatorlus^ a
term which indicates that the surgeon had been
fortunate enough by his attainments to merit, and,
we hope, receive double fees for his services.
All his antiquarian study was looked upon by
Simpson himself as no more than a relaxation.
Fatigued by days and nights of anxious consecu-
tive professional work, he would suddenly dash off
for a day into some part of the country where he
knew there was a likely "find," leaving patients
and students to the care of his assistants. Here he
would press into service and infect with his spirit
all sorts of local worthies from the squire or laird
down to the labourer, who woke up at his stimu-
lation to find that what had been of no concern
to them and their fathers before them — perhaps
objects of vituperation or superstitious dread — were
objects of keen delight and interest, and actually
157
SIR JAMES SIMPSON
valuable to this astonishing man. Once on a pro-
fessional visit to Fifeshire he quite casually discovered
some remarkable though rough carvings in caves,
representing various animals and curious emblems,
and he was able to show that they presented features
hitherto unnoticed. Fifeshire was famous for its
underground dwellings, or, as they are locally called,
"weems" — a term which gave origin to the title
of the Earldom of Wemyss. After such an excur-
sion he would return to Queen Street full of boyish
spirits, eager to narrate his discoveries to interested
friends, and refreshed ready to resume the daily round
of work. Archaeology was his hobby — the hobby on
which he rode away for refreshment and relief from
the monotony of his life's work ; not only did the
hobby consta'ntly restore his flagging energies, but as
it is given to few men to do, he put new life into his
hobby whenever he bestrode it.
In the conduct of his practice he was somewhat
negligent. He was one of the old school in these
matters ; he trusted his head rather than paper, and
his head had had such a careful self-imposed training
since childhood that it was a good servant. But
where the brain has such enormous duties to perform,
those which appear to it unimportant must of necessity
be comparatively neglected.
Had he been more careful of pounds, shillings, and
pence, he would have been more attentive to the
details of practice. To Simpson, provided he liad
158
ARCHEOLOGY— PRACTICE
sufficient money for all his wants — and his wants
were wide, for they included those of many others
— pecuniary and business matters were of secondary
consideration. In his student days he had lived
carefully, accounting, as has been seen, for every
trivial expenditure to those to whom he was indebted.
But now he was free from the harassing necessity
of exercising rigid economy, he cast aside the
drudgery of business methods and disdained com-
mercial considerations. He certainly received some
very large fees, but the curious mixture of human
beings who crowded his waiting-rooms were treated
a.11 alike whether they paid princely fees or no fee at
all ; lots were drawn daily for precedence, and they
entered his presence according as they drew. His
valet seems to have attained considerable skill in
estimating the probable remunerative value of a
roomful of waiting patients, and would grumble at
night if on emptying tne professor's pockets, as was
his duty, the result fell short of his calculated antici-
pations. The man did not approve of the master's
habit of giving gratuitous service. There were many
who were never asked for a fee, and many others
whose proiFered guineas were refused. Simpson would
not ask for money from those to whom he thought it
was a struggle to pay him ; the magnitude of his
profit-yielding practice rendered this form of charity
possible for him ; from the really poor he always
refused remuneration. His house was filled with all
^59
SIR JAMES SIMPSON
sorts of presents from patients, grateful for benefit
conferred, grateful for generosity and consideration.
He was also a free giver, and besides supporting
orthodox charities made many gifts of goodly sums to
persons who appeared to him to be in want, or who
succeeded in impressing on him their need for help.
He was imposed upon often enough ; not seldom by
pseudo-scientists full of some great discovery which a
little more capital might enable them to complete.
Once he corresponded with an enthusiast of this
description who confessed that he had been break-
fasting on a waistcoat, dining on a shirt, and supping
on a pair of tough old leather boots, with the object
of finding a solid substance, which combined with
lead or tin would form gold — nothing more or less
than the time-honoured philosopher's stone ! To such
a man Simpson gave freely not only once.
To young students entering upon professional life
with no other capital than their newly acquired
qualifications to practice, he was ever generous. The
Scots Universities sent forth many such youths, sturdy
and independent, and with feelings that would be
easily wounded by any attempt to patronise. But his
gentleness, and the sympathy born of his own early
experiences and shining in his eyes, made help from
him something to be proud of.
It could never be urged against Simpson that he
was avaricious. Just as when honours were showered
upon him he accepted them with less thought of
i6o
ARCHEOLOGY— PRACTICE
the personal honour than of the appreciation of his
friends and the public, and rejoiced that they were
pleased ; so he rejoiced in the acquisition of ample
means chiefly because of the pleasure he might derive
therefrom by helping others.
His method of seeing patients was boldly haphazard ;
we learn with astonishment that he kept no list of his
visits to be made, and started a day's round with only
his prodigious memory to guide him as to where he
should go. Such a method must have had the result
that only cases of interest or urgency were seen.
No doubt the able staff of assistants attended to the
others, but these comprised not only sufferers from
trivial complaints but those afflicted with imaginary
ills who had come to see Simpson, not his assistant.
Possibly they had already suffered many things of
many physicians and were none the better. Such
persons blamed Simpson with some reason. In the
case of neurotic persons only was his method not
reprehensible ; continued attendance might have
undone the benefit of the one application, if we
may so term it, of his strong personality, which
sometimes was all that was required, so superstitious
was the reverence for his powers. A precise system
of registration of engagements and visits ought cer-
tainly to have been adopted. We can sympathise with
those who felt aggrieved that they could not obtain
more attention from the great man, but it must be
remembered that by his own method he saw a great
l6l M
SIR JAMES SIMPSON
number of difficult and dangerous cases, and was able
to originate out of his wide and unprecedented experi-
ence, modes of treatment which are to-day valued
highly and successfully made use of by his professional
successors. He never wittingly left a fellow-creature's
life in danger, but would hasten at all hours to cases
of real urgency.
As is usual where large numbers are striving after
the same object some were highly careless in their
communications with him. Fees were sent to him
with a request for a receipt, but no address was given.
Engagements were asked for by persons who neglected
to say at what hotel they were staying ; and others
worried him for letters on quite trivial subjects. On
one occasion, it is authentically related, a ten-pound
note was forwarded to him by a man who might more
reasonably have paid one hundred pounds. The note
was somewhat carelessly not acknowledged, and the
sender kept writing letters demanding an answer in
increasing severity of tone. But he was left to rage
in vain. A few nights later Simpson's sleep was
disturbed by a rattling window ; in the dark he rose
and groped for a piece of paper wherewith to stufF the
chink and stop the irritating noise. His only com-
ment next morning when his wife, having removed
the paper and discovered its nature came to him with
it, was, " Oh ! it's that ten pounds ! "
There was a great want of method in all his
arrangements, and Dr. Duns confesses to having had
162
ARCHAEOLOGY— PRACTICE
considerable difficulty in arranging Simpson's letters
and papers, so carelessly were they kept.
The leading hotels in the city benefited by Simpson's
reputation. Patients and pilgrims filled their rooms
long before tourists began to crowd Scotland as they
do to-day. When Simpson was elected to the Chair of
Midwifery loud complaints were uttered by the hotel
proprietors. His predecessor, Professor Hamilton, had
been a man of such wide reputation that they derived
much profit from the patients sent in from the sur-
rounding country to be attended by him. Hov/
could a young man like Simpson equal this ? And
yet when he died there was more than one hotel
proprietor who could attribute no small measure of
his own success to the patients and visitors who
crowded not only from the country districts of
Scotland but from the most remote parts of the
British Empire, as well as from the great cities
of Europe and America, to gain help or speech from
or perhaps only to see this same Simpson. And his
fame had reached the high point it ever after main-
tained when he was but a young man — before he was
forty years of age. It was estimated that no less than
eighty thousand pounds per annum was lost to the
hotel, lodging, and boarding-house keepers of Edin-
burgh when he died.
163
CHAPTER X
PERSONAL PROFESSORIAL — PROFESSIONAL
His genius — Fertility of resource — Personal influence — Work in
obstetrics and gynaecology and surgery — His lecturing and teaching
— The healing of wounds — Acupressure — Hospitalism — Proposal
to stamp out infectious diseases.
PROFESSOR A. R. SIMPSON has said that his
uncle' Sir James Simpson's genius showed itself
in his power of seeing things, in his power of adapting
means to ends, and in his power of making others see
what he had seen and do what he had done. We
have seen these characteristics displayed in his work
upon anaesthesia ; it is literally true that he left no
stone unturned to gain his end and to make others
look upon anaesthesia in the same light as he regarded
it. He declared all the while that if he found the
opposition to the administration of chloroform in
midwifery practice too powerful to conquer alone, he
would finally overcome it by bringing about such a
state of public opinion on the subject as would compel
the profession to adopt his methods.
164
PERSONAL, ETC.
Whether we regard Simpson as a physician or as a
surgeon, as a gynaecologist or as an accoucheur, we
find that his success was always due to the same
causes. He possessed no secret remedies such as an
ignorant and imaginative section of the public often
credit to successful medical men. He performed no
operations with which other surgeons were not
equally familiar and equally capable of performing ;
indeed he frequently sent his surgical cases to operators
in whose hands he considered they would be more
skilfully treated than in his. In obstetrics and
gynaecology his skill arose not only from his unrivalled
experience, but also from his power of rapid diagnosis,
and his promptness and boldness in treatment.
His readiness in resource was unfailing. On
one occasion, it is related, during an operation the
bottle of chloroform was knocked over and its contents
were spilled upon the carpet before the surgeon had
completed his work ; whilst his colleagues were
wondering what was to be done or how a further
supply of the anaesthetic could be obtained with
sufficient speed, Simpson was on his knees hacking
out with his knife the portion of carpet on which
the chloroform had just fallen ; and by means of
this extemporised inhaler the operation proceeded
uninterrupted to the end.
He carried his distinguishing energy and thorough-
ness into every branch of his work ; even in extempore
speeches made at meetings of professional societies, he
165
SIR JAMES SIMPSON
placed facts before his listeners in so convincing and
lucid a manner out of the extensive variety of his
knowledge, and aided by his great memory, that if he
did not in reality gain the point he argued in favour
of he generally appeared to do so. On such occasions
too his imperturbable temper was a valuable weapon.
There is no doubt that the genial professor availed
himself fully of the unbounded confidence placed in
him by his patients. Those of us who did not know
him cannot appreciate what we have already said, that
the charm of his personality was one of the greatest
factors of his success in practice, and of his social
success ; there is the risk of the appearance of
exaggeration in any description of this personal
influence. The sympathy of his heart, a real sym-
pathy, not ' a thin professional veneer, was made
manifest by deed as well as word. It aroused in
his patient, quite unconsciously to both, a feeling
that this man, above all other men, understood his
complaint ; that he, the sufferer was the chief, if not
the only object of his thought and care. It was said
over and over again of him that his words and look
did more good than all his physic, so able a wielder
was he of that healing power which reaches the
body through the mind. Those who knew him not,
but falling sick hastened to Edinburgh to be healed
by him, were oftentimes cured simply because they
felt beforehand that he would cure them. They
followed unconsciously the ancient command of the
1 66
PERSONAL, ETC.
Talmud, where it says, " Honour your physician
before you have need of him," and went to him full
of respect and fired by faith. Wise men have striven
through all ages to take advantage of this influence of
the mind over the body, and the necessity of possessing
a healthy mind if the body is also to be healthy. A
striking proof of the antiquity of the thought has
been recently furnished in a fashion that would have
delighted Simpson. On a papyrus, dated a.d. 200,
brought to light by Egyptian explorers, it is written
that Christ said : " A prophet is not acceptable in his
own country, neither doth a physician work cures
upon them that know him."
The advances which Simpson made in the science
and practice of both midwifery and gynaecology w^ere
due to the magnitude of his experience and the
readiness of his genius to profit by experience. His
one thought being the relief of suffering and the
prolongation of life, he approached the bedside as
a man with less high aspirations would fail to do.
He considered only the patient's interest, and gave
his genius free play. He took midwifery and gynaeco-
logy by storm, and urged them on to great developments ;
he believed in observing, helping, or imitating nature
rather than acting, as his predecessors had done, upon
preconceived ideas which oftener than not ran con-
trary to nature's commands. He avoided meddlesome-
ness, and stepped in only as the ally of nature. He
took numerous hints from bygone practitioners and
167
SIR JAMES SIMPSON
writers, and developed them. To-day we are profiting
by his teaching, and the instruments which he devised
or perfected.
To mention all his suggestions and all his contribu-
tions to the arts which he specially practised would
here be obviously impossible as well as out of place ;
but to medical readers the mention of one instrument
associated with his name, and known as the sound^ will
give a small indication of how much we are in his
debt. The principle of this instrument had been
known long before he took it in hand, but it was left
for him to introduce it into practice, perfect it, and
preach its value in diagnosis and treatment. So
thorough was his work, so farseeing his science, that
our knowledge of its utility has scarcely been added
to since he -first drew attention to it in 1843.
Towards operative work his attitude was character-
istically conscientious. We are told that he habitually
put the following question to himself when contem-
plating a serious operation : " Am I conscientiously
entitled to inflict deliberately upon my fellow-creature
with my own hands the imminent and immediate
chance of death for the problematic and prospective
chance of his future improved health and prolonged
life ? " The fact that he habitually thus questioned
himself is an evidence of the state of surgery at that
time. Operations were undertaken only as a last
resource to save life ; the surgeon knew full well that
he placed his patient in further peril merely by cutting
168
PERSONAL, ETC.
through the skin, in a manner which has now happily
become a thing of the past.
His work was so pre-eminently practical that he
never stopped to collect together his experiences
into a scientific treatise. Although he revivified
midwifery, and was one of the original founders
of gynaecology, he left to aftercomers the labour of
studying what he had done, and drawing the conclu-
sions on which to strengthen the fabric of the science.
His pamphlets, papers, and reports are very numerous.
It would be wrong to say that modern thought has
approved all that he wrote ; but however much time
and increased knowledge may have modified his teach-
ing, they have not detracted from the value of his
researches, discoveries, and suggestions, or from the
stimulating influence of his work upon contemporary
practice and thought.
As a lecturer and teacher Simpson succeeded as in
the other branches of his work. His brilliant exposition
of his subjects and his careful practical manner of
teaching his young listeners doubled the fame which
had begun with his predecessor, Professor Hamilton,
and has ever since belonged to the Edinburgh school
of obstetricians. But here again his personal attrac-
tiveness and power gained for him the greater part
of his success. In the words of the Lancet^ written
when reviewing a posthumous collection of some ot
his writings, his lectures used to brighten the gloomy
days of the Edinburgh winter ; in perusing the
.69
SIR JAMES SIMPSON
publication under review, Edinburgh men would
" almost think they saw the big head and face of the
great obstetrician, as they used to see him beaming
with satisfaction or twinkling with genial humour as
he told a good story, or related a happy case, illustrative
of his own bold and original practice." Both as a
lecturer and as a bedside teacher he captured his
students by the charm of his diction, the wide range
of his knov/ledge, and as Professor Gusserow has
pointed out in his masterly memoir, by his peculiar
talent of having his knowledge at his fingers' ends,
and that often in very remote details.
Year by year he never failed to obtain the affection
of his students ; scarcely a man that had been taught
by him but would proudly boast that he was his
friend as well- as his teacher. He treated his large
class in a confiding spirit — not as the superior person
delivering ex cathedra utterances, but as the friend
rejoicing in his function of admitting those around
him into the knowledge in which he seemed to
revel. He had a happy method of getting on good
terms with his audience before proceeding to the
serious business of the lecture. When his health
began to fail he was sometimes unwillingly laid aside,
and the lectures were delivered by a substitute. On
one occasion he re-appeared pale, weak, and lame,
after such an enforced holiday, and was greeted
enthusiastically by a crowded class. He told them
that his servant had said to him that a rumour was
170
PERSONAL, ETC.
abroad that he was in Morningside Asylum. He had
asked what answer he had made, and heard that he
had replied that so far from being wrong in his mind
his master was writing a book in bed. While he did
not say that this answer was strictly correct, he was
happy to assure them, his pupils, that he was quite right
in his mind, although a friend had hinted that morn-
ing that he' was rather weak in his understanding !
Old fellow-students meeting each other in after life
as staid practitioners take pleasure in recalling the
idiosyncrasies and peculiarities of their teachers ; it is
probable that no professor has ever been talked over
with the appreciation which breathes through the
reminiscences of Simpson conjured up by those whom
he taught.
Simpson left his mark in other departments besides
those of the subject of his professorial chair and of
anaesthesia. About ten years after the introduction of
chloroform he turned his attention to the process of
wound-healing — the repair of necessary wounds in-
flicted by surgeons in the course of their work — and
although he was promptly told to go back to his
midwifery, he worked persistently at the subject. In
those days the subject was the most burning one in
surgery and the methods employed to bring about suc-
cessful results varied in different schools. The object
of all methods was the same, viz., to obtain a healthy,
clean, and sightly result after an operation ; to leave
the part which had been of necessity cut in a condi-
171
SIR JAMES SIMPSON
tion as nearly as possible approaching that in which it
had been found, without the incidence of any of the too
frequent grave complications. Surgeons did not re-
cognise at first the power of nature to effect for them
what they strove after ; they thought to attain their
object by compelling the tissues to heal as they desired
by complicated applications, and many were the layers
of ointments and masses of dressings heaped on wounds
for this purpose. For a long time all efforts were
directed to the discovery of some specific substance,
the application of which would give the necessary im-
pulse towards healing in the desired manner. Before
Simpson's day it had been generally recognised that the
cause — but its nature was quite undreamt of — of the
trouble lay in the air surrounding the wound, and more
dressings were piled on to keep out the air. But at the
same time bleeding was arrested by tying the cut
arteries with Hgatures — chiefly silken — and these were
left with long ends hanging out of the wound to work
their way out by a process of ulceration, or irritation or
the tissues until liberty was obtained. This process was
practically incompatible with the ideal form of healing,
known as healing hy first intention^ /.f., union without
appreciable loss of substance or the formation o^ pus or
matter. So-called "surgical fever," secondary haemor-
rhage, and blood-poisoning were the frequent fatal
results of operation wounds treated in this manner.
Simpson and others thought to prevent these alarming
diseases by devising other means of closing the arteries ;
172
PERSONAL, ETC.
thinking that if some method or material were used,
which nature resented less, the wound would more
readily close by first intention. In 1858 Simpson
stated that he had for some time past been experi-
menting with substitutes for the ordinary silk and
thread ligatures, and in the course of his experiments
had made use of iron, silver, and platinum wires. In
his usual way he hunted up old authorities, and found
a record of both silver and gold threads having been
experimentally used by bygone practitioners. He
seems to have been pleased with his results, stating
that he found the tissues much more tolerant of these
metallic ligatures than they were of the ordinary
organic ones ; that only "adhesive inflammation," not
ulcerative suppurative inflammation, was excited. This
success, however, was probably due to the superior
cleanliness of the metal, but this he did not recognise ;
had he done so he might have been led to strive after
surgical cleanliness, and have partly anticipated the
great work done subsequently by others. He went off],
however, on a different line, and searched for some
readier method of using metallic means of closing the
blood vessels, being stimulated by the desire to abolish
ligatures altogether. Thus he was led, after ten years'
careful research, to the introduction of a method en-
tirely original — that of Acupressure, This consisted in
the introduction of a fine needle through the tissues
across the course of the artery, so that while the needle
pressed upon one side of the artery the resisting tissues
SIR JAMES SIMPSON
of the body exerted counter-pressure on the opposite
side. He claimed for his method the merits of sim-
plicity, elegance, and cleanliness, and urged that not
only did the tissues tolerate the needle as they did not
tolerate silk or hemp, but that unlike the ligature the
needle could be withdrawn as soon as nature had
closed the blood vessel by the process of coagulation of
the blood v/ithin it set up by the pressure ; thus the
prolonged irritating presence of a body within the
wound which delayed healing until it had ulcerated its
way out was rendered unnecessary, and a better and
more rapid result was attained. He verified his theo-
retical considerations by experiments on animals and
in one or two operations on the human subject, and
in 1859 read a communication on the subject to the
Royal Society of Edinburgh.
The paper was written under great pressure of
work, indeed he stated that at that time he was
hardly ever able to write except when himself " con-
fined " ; it was hastily prepared to take the place
of that of another Fellow which had failed to be
forthcoming a few days before the appointed meet-
ing. It was composed at a country house where
he had to sleep for two or three nights watching
a case of diphtheria. It was headed as usual by a
Shakspearian quotation, this time briefly in Justice
Shallow's words, thus : — " Tut, a pin ! " On the
evening of its delivery an abstract of the paper was
forwarded to the leading surgeons in England, Europe,
174
PERSONAL, ETC.
and America, and diverse were the opinions ex-
pressed.
In Scotland the new method met with the greatest
favour and the strongest opposition at one and the
same time. Throughout Europe and America it
was everywhere received with applause and support.
Excellent results were obtained when the method was
properly applied, but technical considerations, particu-
larly the difficulty of using it upon blood vessels far
removed from the surface, rendered it unsuitable for
universal application.
Professor Syme met the innovation with vehement
opposition ; possibly he resented this intrusion of the
gynaecologist into the regions of general surgery.
He took into his class-room one pamphlet on the
subject by Simpson, v/hich had especially aroused his
wrath ; he stormed at the author before his students
for " his vulgar insolence," and then, in a dramatic
scene, expressed the violence of his contempt by
savagely tearing the pamphlet into pieces and casting
it away. In a subsequent controversy between these
two old opponents, who had been temporarily united
by Simpson's conduct in consulting Syme profes-
sionally, by their joint action against homoeopathy,
and by Simpson's defence of Syme when publicly
attacked by an English surgeon, the feud was renewed.
Simpson persisted for years in collecting reports or
operations in which acupressure was employed, and
published them from time to time in the British
^75
SIR JAMES SIMPSON
Medical Journal and elsewhere. In 1864 his work
on the subject took the form of a volume contain-
ing 580 quarto pages. His friends endeavoured to
rank acupressure with chloroform as one of the bless-
ings to humanity made manifest by him. He himself
recognised that he had failed to gain for acupressure a
place in practice such as he had gained for chloroform,
but he looked forward to a time, perhaps a quarter of
a century distant, w^hen his method would be beginning
to be thought about. In this he was mistaken for,
on the contrary, acupressure was beginning to be
forgotten long before twenty-five years had elapsed.
Another worker on more strictly scientific lines had
by that time made healing by first intention, without
complications, the rule instead of the exception, and
conferred a benefit on humanity as great if not greater
than that of anaesthesia. In 1867, while Simpson was
still alive, Mr. (now Lord) Lister (then a hospital
surgeon in Glasgow, and subsequently Syme's successor
in Edinburgh) enunciated the new principle of " anti-
septic surgery," which recognised the living infective
micro-organisms of the air as the cause of the trouble
in wounds. He directed that as these invisible organisms
(known only by means of the microscope) were
present everywhere in the air, found their way into
all sorts of wounds, and set up the decomposition
which led to disastrous results, they were to be destroyed
or excluded from wounds ; and he suggested effective
means of accomplishing this end. He further abolished
176
PERSONAL, ETC.
the long ligatures which irritated by their presence,
and by the organisms they conveyed into the wound
when imperfectly cleansed as they usually were ; and
substituted non-irritating ligatures which nature herself
was able to remove by the process of absorption. The
recognition of this antiseptic principle effected a much
needed revolution in surgery, and in this revolution
acupressure was practically annihilated. Simpson did
not live long enough to see the complete establishment
of the Listerian principle ; at first he vigorously op-
posed what he considered to be an attempt to retain
the old-fashioned ligatures in preference to his new
acupressure ; but with his penetrative eye he must
have foreseen that should the new practice prevail and
short absorbable ligatures be made possible, acupressure
would be completely superseded.
In the estimation of the writer of the obituary
notice of Professor Simpson in the British Medical
yournal^ the greatest of all his works was that
undertaken in the subject of Hospitalism. As early as
1847 he had been horrified to read in a report of the
work done in the Edinburgh Infirmary, that out of
eighteen cases of primary amputation performed during
a period of four years only two survived. He faced
this fact with the courage of the reformer, and sought
far and near for other facts to support the theory
which he gradually evolved, that this melancholy
failure of surgeons to save their patients' lives was
due not so much to the operation or the operator
177 N
SIR JAMES SIMPSON
as to the environment of the patient. In later years
he himself often shrank, on account of unfortunate
experiences, from performing capital operations which
he had formerly unhesitatingly undertaken. The
unhealthiness of hospitals had long been recognised ;
and was especially observed at times when they were
overcrowded, as happened during war time. When
the public had thoroughly grasped the utility of anaes-
thetics, and recognised that operations could be
performed painlessly, there were fewer refusals to
submit to the knife ; there was a rush to the hospitals,
and the surgical wards throughout the length and
breadth of the land became crowded with men and
women actually longing for operation. Amongst
these all the dreaded sequelae of surgical interference,
which no power seemed able to check, ravaged with
alarming severity.
It is to Simpson's credit that he perceived how the
introduction of anaesthesia had taxed the hospitals and
bewildered the operators, who sought diligently but
unsuccessfully in every direction for some means of
reducing hospital mortality. He was one of the first
to set to work with method to investigate this question
of Hospitalism.
It was towards the end of his career, when the old
Edinburgh Infirmary stood condemned, and various
proposals for rebuilding it on a new site and improved
plan were under discussion, that his voice was most
loudly heard. For many years he had thought and
178
PERSONAL, ETC.
taught that the great mortality after operations in
hospitals was due to the impure state of the air therein,
derived from the congregation of a large number of
sick persons under one roof. He picturesquely stated
that the man laid on a hospital operating table was
exposed to more chances of death than the English
soldier was on the field of Waterloo. His original
suggestion was that hospitals might be changed from
being crowded palaces, with a layer of sick on each
floor, into villages or cottages, with one, or at most
two, patients in each room ; the building to be of
iron, so that it could be periodically taken down and
reconstructed, and presumably thoroughly renovated.
This drastic proposal brings nowadays a smile to the
lips, for we see now how he was groping in the
dark ; but the magnitude of it is but the shadow of
the evil it was designed to cure. The change was
so great as to be impracticable in the eyes of most
men ; he, on the other hand, contended that it was to
be of incalculable benefit to humanity, and, therefore,
no difficulty, however great, should be allowed to
stand in the way. He did not understand that the
evils arose not from the air itself but from what was
in the air, known to us now as the micro-organisms.
His remedy was a proposal to run away from the evils
without receiving any guarantee that they could not
and would not successfully pursue. Had Lister not
arisen, Simpson's proposals might have possibly pre-
vailed, for he laboured with all his persistent energy.
179
SIR JAMES SIMPSON
The general belief of the profession — but it was no
more than a belief — was that operations performed in
country practice were not so frightfully fatal as those
performed in town hospitals. This was Simpson's
opinion, and he determined to test its truth by appeal
to facts. He drew up a circular with a schedule for
the insertion of results in a statistical form, and sent
it far and wide amongst country practitioners. He
awaited the result with anxious expectation ; the
circular asked for a plain statement of facts only, and
for all he knew the facts might be against his theory ;
but they were not. From all over England and
Scotland, particularly from mining districts, where
severe operations after accidents were common, the
filled-up schedules flowed in, to the number of 374.
These were collected, carefully classified and sum-
marised. The operations selected were amputations,
and the result briefly was this : —
Total number of cases - 2,098) Mortality,
„ „ deaths ■ 226 j io"8 per cent.
The relative mortality of the different amputations
was also shown : —
669 Thigh cases ; deaths, 123 ; mortality, i8"3 per cent.
618 Leg „ ; „ 82; „ 13-2
433 Arm „ 5 „ 19 ; „ 4-3
378 Forearm,, ; „ 2; „ 0-5 „
The table on the next page compared the results of
operations for injury with those performed for disease.
180
PERSONAL, ETC.
For Injury.
For Disease.
Cases.
Deaths.
Mortality.
Cases.
Deaths.
Mortality.
Thigh
313
80
per cent.
25-5
356
43
per cent.
I2*0
Leg
409
57
13-4
209
25
I2-0
Arm
344
14
4-0
89
5
5-6
Forearm
318
2
0-6
60
0
—
These statistics were accompanied by an exhaustive
detailed examination and explanation ; every possible
point of attack was considered and protected. " I
doubt not," he said, " that the segregation of the sick
from the sick — every diseased man being a focus of
more or less danger to the diseased around him — is a
principle of no small moment and value." He attri-
buted the comparative brilliancy of these statistical
results to the isolation of the patients only ; he
endeavoured to show that the operations were often
performed amidst dirty and squalid surroundings, on
dirty and squalid persons. He did not attribute
sufficient importance to the fact urged by many of
his correspondents, who supported his general con-
tentions almost to a man out of their own experience,
that where fresh air, ventilation, and cleanHness pre-
vailed, the results were always the most satisfactory.
The next step was to take hospital statistics of
181
SIR JAMES SIMPSON
similar operations, and the general result appears in
the table on page 183.
This testimony to the truth of Simpson's opinion
was more pronounced than even he himself had
anticipated. " Shall this pitiless and deliberate sacri-
fice of human life to conditions which are more or
less preventable be continued, or arrested ? Do not
these terrible figures plead eloquently and clamantly
for a revision and reform of our existing hospital
system ? " This was his cry until at length breath
failed him. The opposition was not strong, but the
support was weak. Although there was much criti-
cism, his conclusions were scarcely called in question
at all ; trifling holes were picked in his statistics, but
his contentions were universally acknowledged to be
correct ; a few reformers only, persuaded as he was of
the evils of hospitalism and working at the subject,
lent him their advocacy. But he alone stood unper-
turbed at the extent of the evils and the magnitude
of the change which he proposed in order to up-
root them ; death laid him low as he stood, but not
before he had modified his proposals by suggesting
that existing hospitals might be reconstructed, and
new hospitals built on the now almost universally
adopted pavilion system on which the new Edinburgh
Royal Infirmary was one of the first to be built.
The steady advance of aseptic surgery has slowly
but surely brought about the results which Simpson
strove to attain by a radical measure. The enemy
182
PERSONAL, ETC.
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SIR JAMES SIMPSON
wihich had baffled surgeons for centuries was revealed
by Lister. He sent surgeons smiling into the operat-
ing-room practically certain of success instead of
dreading the terrible onslaught upon their own
handiwork of the formerly unseen and unknown
destroyer. The death rate of operations is being
daily brought nearer and nearer to vanishing point.
In his review of the progress of wound treatment
during the Victorian Era pubHshed in the Diamond
Jubilee number of The Practitioner^ Mr. Watson
Cheyne says the mortality of major operations does
not now exceed in hospitals more than three or four
per cent., and this is made up practically entirely by
cases admitted almost moribund and operated on in
extremis with faint hope of survival. The field of surgery,
too, has been vastly enlarged, and the term " major
operation " includes not merely operations of necessity,
undertaken through ages past as the only possible
means of saving life, but also operations which have
become possible only in recent years — some of them
performed merely to make the patient "more comfort-
able," or even only "more beautiful." And this
glorious result is due, as Mr. Cheyne truly says, to
the immortal genius of Lister.
In 1867 Simpson propounded in the Medical Times
and Gazette a proposal for stamping out smallpox and
other infectious diseases such as scarlet fever and
measles. In spite of vaccination, which, however, was
imperfectly carried out, smallpox alone carried off five
184
PERSONAL, ETC.
thousand lives annually in Great Britani. A serious
outbreak of rinderpest in the British Islands amongst
cattle had recently been arrested and exterminated by
the slaughter of all affected animals. The disease
spread as smallpox did by contagion, and Simpson fell
to wondering why smallpox could not also be ex-
terminated. His paper was a noteworthy contribution
to the then infant science of Public Health, and his
proposal, which was, however, universally regarded as
impracticable, sprang from his courageous enthusiasm
as did that concerning hospitals. He suggested that
the place of the pole-axe in the extermination of
rinderpest might in the arrest of smallpox be taken by
complete isolation, and he laid down simple but rigid
rules for its enforcement. An attempt was made to
utilise these a few years after when an epidemic of
fatal violence broke out in Edinburgh. He v/as in no
way an anti-vaccinationist, but his isolation measures
were too strong for the people in those days. We are
not surprised that he boldly proposed this measure, for
he related glaring instances of neglect of the simplest
precautions. Beggars held up infants with faces
encrusted with active smallpox into the very faces ot
passers-by in the streets of Edinburgh ; and on one
occasion a woman was found in Glasgow serving out
sweetmeats to the children of a school with her hands
and face covered by the disease. He cried aloud for
legislation to prevent such gross abuses, which he did
not hesitate to stigmatise as little short of criminal.
185
CHAPTER XI
FURTHER REFORMS HONOURS
Professional and University Reform — Medical women — Honours- — The
Imperial Academy of Medicine of France — Baronetcy — Domestic
bereavement — The University Principalship — Freedom of the City
of Edinburgh — Bigelow of Boston — Views on education — Graduation
addresses,
PROFESSOR SIMPSON took a warm interest
in medical politics, and made himself heard as
a member of the Senatus of the University. That
body was not renowned for any spirit of harmony
prevailing in its midst ; it included the medical pro-
fessors many of whom were in professional opposition
to each other and were actuated by conflicting interests.
The rivalry prevailing amongst the leaders of the pro-
fession in the Scots capital was amusingly shown in
one of Sir James's letters, where he related how
Professor Miller had just given a capital address to the
young graduates and recommended them to marry
chiefly because Mr. Syme had advised the reverse two
years before. " At least," he said, " so Mr. Syme
i86
FURTHER REFORMS— HONOURS
whispered to me, and so, indeed, did Miller himself
state to Dr. Laycock ! "
On the principles of Medical Reform and University-
Reform the professors were, however, practically
unanimous, but their interests came into conflict with
those of the extra-academical school. The two
opposing bodies worked hard to gain their own ends
when a Parliamentary Committee was appointed in
1852 to inquire into medical reform. The modern
Athens became once more disturbed by wordy war-
fare. The general ends aimed at by the reformers
were the obtaining of a proper standing for qualified
practitioners ; some satisfactory means of enabling the
public to distinguish between regular and irregular,
quack, practitioners ; and to define the amount of
general and professional knowledge necessary for
degrees and qualifications. It was also desired to
remove the absurd anomaly whereby, although Scots
medical education was then ahead of English, Scots
graduates had no legal standing in England. The
Medical Act which was passed in 1858 carried out
many of the best suggestions made before the Com-
mittee, and effected desirable improvements both in
the status of practitioners and in medical education ;
but it was inadequate, as time has shown, and the
question of reform still burns. Simpson took an
active interest in the proceedings before the Com-
mittee, and made several dashes up to London to
further the projects which he had at heart. The
187
SIR JAMES SIMPSON
annual meeting of the British Medical Association
was held in Edinburgh in July, 1858, at the moment
when the fate of the Bill hung in the balance. As
the journal of the Association said at the time the fruit
of a quarter of a century's growth was plucked in the
midst of the rejoicings. Sir Robert Christison publicly
stated that owing to Simpson's energetic efforts certain
far-reaching and objectionable clauses, which had
been allowed to creep into the Bill, were expunged
at the last moment. Simpson went up to London
by the night train, employed the following day in
effecting his purpose, and returned the next night ;
this was when the journey took nearly twice as many
hours as now.
The Universities (Scotland) Act was also passed in
1858 ; by it the complete control of the University,
and with it the patronage of many of the Chairs, was
lost to its original founders, the Town Council, who
had so carefully and successfully guided it through
nearly three centuries. The Council did not part
from their charge without a struggle ; in urging
their cause they proudly pointed to the fact that they
had appointed Simpson to the Chair of Midwifery
against the opposition of the medical faculty. To
have elected him, they thought, under such circum-
stances displayed their discernment, vindicated their
existence, and pleaded for the perpetuation of their
elective office.
When the question of the admission of women to
188
FURTHER REFORMS— HONOURS
the study of medicine came up in Edinburgh and
divided the ancient city once more into two hostile
camps, Simpson's sympathies appear to have gone with
the sex to which he was already a benefactor. He
recognised that there was a place, if a small one,
within the ranks of the profession for women ; and
when the question came to the vote he cast his in
their favour. The proposal, however, was rejected,
and has only quite recently become law in the
University.
Numerous honours were heaped upon him during
the last five-and-twenty years of his life. In 1847 ^^
filled the office of President of the Edinburgh College
of Physicians, and in 1852 held the corresponding
post in the Medico-Chirurgical Society. In the
following year the Imperial Academy of Medicine of
France — a body which lacks an analogue in this
country — conferred upon him the title of Foreign
Associate. This was a jealously guarded honour
awarded only to the most highly distinguished men of
the day, and it was conferred upon Simpson in an
altogether unprecedented manner which doubled its
value. According to custom a commission of
members prepared a list of renowned men whom they
advised the Academy to elect ; in the list no British
name appeared although Owen, Faraday, and Bright
were entered as " reserves." On the day of election
the members accepted all the candidates named in the
original list until the last was reached. When the
189
SIR JAMES SIMPSON
president asked for the vote for this individual a
sensational and truly Gallic scene was enacted.
Almost to a man the members rose, and loud and
long proclaimed Simpson's name. Excited speeches
were made, and amidst great enthusiasm he was elected
to the one remaining vacancy by an overwhelming
majority. It had remained for Simpson to prove, as
the President courteously pointed out at the time,
that there existed a greater honour than that of being
elected by the Academy — viz., that of being chosen in
spite of the will of the Academy itself.
This was by no means the only honour av/arded to
him by France. In 1856 the French Academy of
Sciences voted him the Monthyon Prize of two
thousand francs for " the most important benefits done
to humanity." Other foreign societies added their
compliments, and he was elected Foreign Associate of
the Belgian Royal Academy of Medicine, of the
Parisian Surgical and Biological Societies, and of the
Medical Societies of Norway, Stockholm, Copenhagen,
New York, Massachusetts, Leipsic, and other places.
In 1866 his own country made an acknowledgment
of his eminent attainments when the Queen offered
him a baronetcy on the advice of Lord John Russell.
Twice before he had refused a title, but this time
he wrote to his brother that he feared he must accept
although it appeared so absurd to take a title. This
honour was the first of its kind ever conferred upon a
doctor, or even upon a professor, in Scotland. It was
190
FURTHER REFORMS— HONOURS
entirely unsought, and scarcely welcomed by its
recipient for its own sake ; he regarded it not merely
as a personal honour but also as a tardy recognition of
the services of the Edinburgh school in the cause of
medicine. He enjoyed the congratulations which
showered upon him, and felt glad when the citizens
flocked to Oueen Street to express their feelings,
much to Lady Simpson's delight. The medical papers
unanimously approved of the honour, the Lancet re-
marking that apart from his connection with chloro-
form, Simpson was distinguished as an obstetric
practitioner, as a physiologist, as an operator, and as
a pathologist of great research and originality.
Domestic bereavement quenched the rejoicings over
the baronetcy, and condolences displaced congratula-
tions. He fell ill for a time himself, and in a condition
of unusual mental depression spoke of the baronetcy as
appearing even more of a bauble in sickness than in
health. In less than a fortnight after the offer of the
title his eldest son David died after a short illness. He
had been educated for the medical profession, and was
a youth of considerable promise and of an earnest
temperament ; his death fell as a severe blow, and
Simpson even contemplated abandoning the baronetcy
which had not yet been formally conferred. The
words of his friends, however, and the thought that
his dead son had particularly insisted on its acceptance,
persuaded him.
A coat of arms had to be drafted for the new
IQI
SIR JAMES SIMPSON
Baronet, and this was a pleasant interest for one of his
tastes. The family history was searchingly entered
into, and the arms of his father's family were differ-
enced on the most correct lines with those of the
Jervays from whom his mother had sprung. In the
matter of a crest he was able to be boldly original, and
adopted the rod of ^sculapius over the motto Ficto
dolor e^ and thus handed down to his family the
memory of his great victory over pain. In June of
the same year, 1866, the University of Oxford con-
ferred upon him one of the few honours which reached
him from England in awarding him the honorary
degree of Doctor of Civil Law. The University of
Dublin made him an honorary Doctor of Medicine,
and he was created an honorary Fellow of the King's
and Queen's College of Physicians of Ireland.
By the death of the veteran Sir David Brewster, in
February, 1868, the office of Principal of Edinburgh
University fell vacant. This post is a survival from
the earliest days. The College out of which the
University grew was estabhshed in 1583 by the Town
Council under a charter granted by James VI. Only
one regent or tutor was necessary at first to teach the
" bairns," as the students were termed in the contract
entered into between Rollock, the first regent, and
the city fathers. Rollock was promised that as the
college increased " in policy and learning " he should
be advanced to the highest post created. By his own
efforts the number of students increased so greatly
192
FURTHER REFORMS— HONOURS
that within the first few years several other regents
were appointed, and the Council, remembering their
promise, dignified him with the title of Principal or
First Master in 1586. This office was held during
the succeeding two centuries by a series of more or
less worthy men, prominent among whom were
Leighton, afterwards Archbishop of Glasgow, and
William Carstares, better known as a statesman and
for his connection with the Rye House Plot in 1684.
During Carstares's tenure the tutors were turned into
professors, and the college became more strictly speak-
ing a university, although from the first it had assumed
without any right by charter the function of degree-
granting. Although the utility of the post quite vanished
when the college became a university, and the princi-
pal had no place in the constitution of a university,
nevertheless the principalship was not abolished. The
Universities Act of 1858 recognised the office, but
only as that of an ornamental head, acting as president
of the assembly of professors constituting the Senatus
Academicus. The salary is a thousand pounds a year
with an official residence, not within the precincts or
the University. The former head master of the
college, known by and knowing every student, became
a sinecurist of whose existence it is no exaggeration to
say many of the students are, through no fault of
their own, unaware. Brewster had been a distinguished
occupant of the post — distinguished not as a principal,
for he received the appointment only at the age of
193 o
SIR JAMES SIMPSON
seventy-eight, but as a scientist. To the public he
was best known as the author of the " Life of Sir Isaac
Newton," and as the inventor of the kaleidoscope. It
is said that Brewster never spoke as much as five lines
at the meetings of the Senatus Academicus without
having previously written them down ; and it is
probable that this lack of spontaneous utterance from
the Chairman gave the tone to the assembly. The
rival professors doubtless nursed their animosities for
some less dignified meeting-place, differing there only
on the most correct academic lines.
It is not surprising that Simpson at first refused to
be a candidate for the vacant post. He would un-
doubtedly have made an unrivalled figure-head for his
Jlma Mater ; he was the leading figure in Scotland
already and " did the hospitalities " of Edinburgh
to distinguished visitors of all classes. But he would
probably have been obliged to resign his professorship
and have thus been cut off from his sphere of greatest
usefulness ; and although he would have grasped
with ease the details of university afrairs it is open to
question whether he would have suitably filled the
post of president over men to many of whom he was
in professional opposition. The most that the sug-
gestion that he should be a candidate conveyed was a
well-meant compliment, but it would have been a
greater compliment on his part if he had really ended
his life as the ornamental head of the University he
had already done so much to adorn. He would
194
FURTHER REFORMS— HONOURS
certainly have turned his position to good account,
and perhaps might have earned the gratitude of all
succeeding students by improving their position in the
University and bettering their relationship with their
teachers — a much needed reform at that time. But
he was a man for more active occupation, and it was
more fitting that he should persevere to the end in the
w^ork of his life. Simpson expressed his opinion that
the most suitable man for the post was the one already
named by Brewster and desired by a majority of the
Senatus ; but that man, Professor Christison, then
over seventy years of age, generously said that Sir
Alexander Grant, an active candidate, w^ould better
fill the post. A strong section of Edinburgh folks
persisted in pushing Simpson, and in deference to
their wishes he consented to enter the lists. It
cannot be said that he displayed any of the eager
energy which had marked his candidature for the
midwifery chair ; but his friends made up for his
comparative apathy. They were met by a strong
opposition, not instigated by his rivals for the post,
but offered by insignificant persons who cherished ill-
will against him and spread untrue statements with the
object of damaging his character. Greatly owing to
the reports spread in this manner he was not elected.
Sir Alexander Grant became the new Principal. The
fact that he could not gain the post was communicated
to him in a letter which reached him one morning
before prayers. He conducted the worship as usual
SIR JAMES SIMPSON
after reading the letter, and when the family had
afterwards all assembled at the breakfast table he
intimated the fact to them and dismissed the subject
from his mind with the quiet remark, " I have lost
the Principalship."
An interesting episode pertaining to this period was
narrated by the Free Church minister of Newhaven.
" The election," he wrote to Dr. Duns, " took place
on a Monday, and it was on the Sabbath preceding,
between sermons, that one of my people, a fisherman,
called on me stating that his wife was apparently
dying, but that she atid all her friends were longing
most intensely for a consultation with Sir James. I
did not know well what to do, for I knew that his
mind was likely to be very much harassed, and I
shrank from adding to his troubles. But in the
urgency of the case I wrote him a note simply stating
that one of the best women in the town was at the
point of death and longed for his help, leaving the
matter without another word to himself. The result
was that he came down immediately, spent three
hours beside his patient, performed, I am told, miracles
of skill, and did not leave her till the crisis was over.
She would, I am assured, have died that evening, but
she was one of the sincerest mourners at his funeral,
and she still lives to bless his memory. After all was
over he went into a friend's house and threw himself
down on a sofa in a state of utter exhaustion. This
was the way in which, without hope of fee or reward,
196
FURTHER REFORMS— HONOURS
and while others were waiting for him able to give
him both, Sir James spent the evening preceding the
election. Some will say it was no great matter after
all. Why, for that part of it, neither was the cup of
cold water which the dying Sir Philip Sidney passed
from his own lips to those of a wounded soldier in
greater agony than himself. But the incident is
recalled whenever his name is mentioned as adding to
the glory of the knight sans peur et sans reproche^ and
the incident I have mentioned in the Newhaven
fisherman's house surely gives to Sir James a place
beside him in the glorious order of chivalrous
generosity."
Among the last of the honours offered to Simpson
was the Freedom of the City of Edinburgh ; a fitting
tribute from the City in which and for which he had so
nobly and untiringly laboured. It was proposed to present
him with the burgess-ticket at the same time that it
was publicly presented to another hero in a different
sphere. Lord Napier of Magdala ; but by his own desire
the ceremony was postponed so far as he was concerned
in order that full honour might be paid to Lord Napier.
At the eventual presentation the Lord Provost made a
short speech recapitulating the achievements for which
they desired to honour him, and referring to his repu-
tation as being great on the banks of the Thames and
the Seine, as well as on the shores of the P'irth of
Forth ; he likewise expressed the pride of his fellow-
citizens that Sir James had remained amongst them
197
SIR JAMES SIMPSON
and had not been drawn away like other men of genius
before him by the attractions of the greater metropolis
of the south. Simpson's reply took the form of an
impromptu review of his career from the time he first
entered the City as a wonderstruck boy. " I came,"
he proudly said, " to settle down and fight amongst
you a hard and up-hill battle of life for bread and
name and fame, and the fact that I stand here before
you this day so far testifies that in the arduous struggle
I have — won."
The accounts of the speeches delivered on this
occasion which reached America raised the indigna-
tion of Dr. Bigelow, of Boston. Reference had been
made to chloroform in a manner which appeared to
slight Morion's work in introducing ether as an anaes-
thetic before chloroform was heard of. In Bigelow 's
estimation Simpson posed as a hero at the expense of
Morton. Simpson had certainly been far from liberal
in his allusions to Morton and others in his article
upon Anaesthesia in the Encyclopaedia Br'itayinica^ and
had written almost entirely about his own discovery.
A controversy was excited, and on his deathbed Simpson
wrote a letter to Bigelow to prove that he had duly
considered the priority and the value of Morton's
and Wells's work. In his concluding sentences he
expressed regret at having taken up so much of his
own and his correspondent's time in such a petty
discussion, but blamed his illness which prevented
him from writing with the force and brevity required.
198
FURTHER REFORMS— HONOURS
"With many of our profession in America," he said,
" I have the honour of being personally acquainted,
and regard their friendship so very highly that I
shall not regret this attempt — my last, perhaps — at
professional writing as altogether useless on my part
if it tend to fix my name and memory duly in
their love and esteem."
The widespread national expression of the sense of
loss and of sympathy which reached Edinburgh from
the United States after Sir James's death testified to
the regard in which he was held from one end to
the other of that country. In Boston itself the
Gynaecological Society, of which he had been the
first honorary member, convened a special memorial
meeting, which was solemn and impressive. He
had not been mistaken in presuming with his last
breath that he held the regard of his American
confreres.
On the subject of education Simpson held what
were considered advanced opinions, but which had
already been expressed by Mr. Lowe. A few years
before his death he delivered a lecture on Modern
and Ancient Languages at Granton, in which he
lamented the common neglect of modern languages
in the education of the day. He had personally felt
the want of a mastery over French and German,
both in the course of his studies and during his
travels; nor did he feel the want compensated for by
his ability to write and talk in Latin. He strongly
199
SIR JAMES SIMPSON
advocated the paying of more attention to the modern
and less to the dead languages, and he urged that
natural science should take its place in the ordinary
curriculum of the great public schools. These views
were used as an argument against his fitness for the
post of Principal of the ancient University.
On three separate occasions it fell to Simpson's
lot to deliver the annual address to the newly-fledged
graduates, which is the duty of the professors of
the medical faculty in rotation. This ceremony
remains deeply impressed in the memory of Edin-
burgh men, simple and dull as it undoubtedly is.
The homily delivered by the orator of the day con-
tains excellent counsels appropriate to the occasion,
but the young man eager to rise and confidently
try his win'gs pays little attention to the words of
wisdom ; unless it be to feel wonder that just as he
is about to leave them, probably for ever, his Alma
Mater and her priests have discovered an affectionate
regard for him and his welfare. A few years later
the struggling young practitioner may perhaps turn
to the copy of this graduation address, forwarded to
him by post with the author's compHments, and find
in such an one as Simpson delivered much to
strengthen and encourage him. In 1842 and 1855
he delivered addresses from which quotations have
already been made ; and in the third one, spoken in
1868, he made a forecast of the future of medical
science, predicting inter alia that by concentration
200
FURTHER REFORMS— HONOURS
of electric or other lights we should yet be enabled
to make many parts of the body sufficiently diaphanous
for inspection by the practised eye of the physician.
It was his habit to commit such lectures to memory
and to dehver them without notes. He was a ready
public speaker on any subject in which he was inte-
rested ; speeches made on the spur of the moment
teemed with pleasantly-put facts and apt anecdotes
from the vast storehouse of his memory. A speech
from Sir James was one of the treats in which Edin-
burgh folks delighted.
201
CHAPTER XII
Failing Health — Death
Poetical instincts — Religious views — Religious and emotional influences
in his life — Doubts — Revivalism — Health — Overwork tells — Bed
— Gradual failure — Death on May 6, 1870 — Grave offered in
V/estminster Abbey — Buried at Warriston — Obituary notices —
Bust in the Abbey — His greatness.
THE etnotional part of Sir James Simpson's
nature found some small expression in versi-
fying both, as we have seen, in early years and in
later days. We know that he was a close student
of Shakspeare, but Miss Simpson states that her
father probably never entered a theatre, so that he
can never have seen a representation. He was
familiar with modern poets, especially with Burns.
It is related that he once tested a lady friend's insight
into the vernacular by quoting from memory for
explanation the following lines from the national
bard : —
" Baudrons sit by the ingle-neuk,
An' wi' her loof her face she's washin',
Willie's wife is nae sae trig,
She dichts her grunzie wi' a hooschen.
202
FAILING HEALTH— DEATH
His own verses were neither better nor worse than
those written by other men whose abilities have led
them to excel in more practical pursuits. In youth
they celebrated student life, or were, as usual,
dedicated to Celia's eyebrows ; in mature life they
were of a more serious, and latterly of a strong
religious description. At all times he delighted in
writing little doggerel verses to his children or friends ;
valueless as such efforts are, they served a useful
purpose ; their composition was a recreation and
pleasant relief to his over-taxed brain, while it was
an amusement to him to watch their effect upon
the recipients, and perhaps to receive a reply clothed
also in the garb of rhyme.
Sir James's example so influenced the people amongst
whom he lived that it is impossible to omit reference
to his attitude throughout life towards rehgion and an
account of what is one of the most interesting phases
in his history. Up to Christmas, 1861, he had been,
in the eyes of the religious public, an ordinary
citizen ; as regular in church-going as his professional
engagements permitted ; thoroughly interested in
Church affairs, and a strong supporter of his own
Church ; possessing to the full the national cha-
racteristic of intimate acquaintance v/ith the letter
of the Old and New Testaments ; and something
of a theologian as well, as his answer to the re-
ligious objections to anaesthesia showed. At that
period, to the delight of many, and the genuine
203
SIR JAMES SIMPSON
astonishment of others among his fellow-citizens,
he became a leading spirit in the strong Evangelical
movement v^hich v\^as then spreading through the
country. "Simpson is converted," cried the enthu-
siastic revivalist. "Simpson is converted now," laughed
those who had opposed every action of his. " If Pro-
fessor Simpson is converted, it is time some of the rest
of us were seeing if we do not need to be converted,"
wisely answered one of his friends. In the ordinary
sense of the word Simpson was not converted. Had
he passed away without developing this latter-day Evan-
gelical enthusiasm, all sects would still have united in
thankfulness that such a man had Hved. Why this
religious revival during the sixties affected him as it
did becomes evident in looking at the religious, moral,
and emotional influences which affected him through-
out his career.
The simple-minded, devout mother, strong in faith
and strong in works, who passed out of his life when
he was but nine years old, left a vivid impression on
the boy's mind. In after years he would call up the
picture of the good woman retiring from the shop and
the worries and troubles of daily life into which she
had so vigorously thrown herself and so bravely
faced even with failing health, into the quiet little
room behind, to kneel down in prayer ; and would
describe how at other times she went about her
work chanting to herself one of the old Scots metrical
psalms :
204
FAILING HEALTH— DEATH
Jehovah hear thee in the day, when trouble He did send
And let the name of Jacob's God thee from all ill defend.
Let Him remember all thy gifts, accept thy sacrifice,
Grant thee thine heart's wish, and fulfil thy thoughts and counsel wise.
He used to relate one memory of her, touching in
its simplicity : how one day he entered the house with
a big hole in his stocking which she perceived and
drew him on to her knee to darn. As she pulled the
repaired garment on she said, " My Jamie, when your
mother's away, you will mind that she was a grand
darner." He remembered the words as if they had
been spoken but yesterday, and subsequently offered to
a lady who had established a girls' Industrial School in
his native village a prize for the best darning.
The simple faith which beat in the life of the
Bathgate baker's household was ingrained into James
Simpson ; he went forth into the world full of it, and
full of the determination that by his fruits he should be
known.
The tender, loving care for his welfare of his sisters
and brothers, particularly of Sandy, who never faltered
in his inspired behef in James's great future, kept alive
in Simpson something of his mother's affectionate
nature, and kindled the sympathies and emotions
which bulked so large in his character. His goodness
was displayed in his kindly treatment of the poor, who
formed at first the whole and afterwards no small part
of his patients. When name and fame and bread
were his, he did not turn his back on the poor, but
205
SIR JAMES SIMPSON
as we have seen, ever placed his skill at their disposal
for no reward, as readily as he yielded it to the greatest in
the land. As in his daily practice, so in his greatest
professional efforts, the revelation of chloroform, the
fight for anaesthesia, the introduction of acupressure,
the crusade against hospitalism, one thought breathed
through his work — that he might do something
to better the condition of suffering humanity. He
never attempted to keep discoveries in his own
hands, to profit by the monopoly, but scattered wide
the knowledge which had come to him that it might
benefit mankind and grow stronger and wider in the
hands of other workers.
In his domestic life he was a tender, loving, and
companionable husband and father, a charming host,
and a warm-hearted friend. "In this Edinburgh of
ours," says a recent writer, " there are familiar faces
whose expression changes greatly at the mention of
his name ; there are men whose speech from formal
and precise turns headlong and extravagant, as if it
came from a new and inspired vocabulary." In
Scotland his personal influence was immense. As
was afterwards written of him, " Great in his art,
and peerless in resource, yet greater was he in his
own great soul ; " such a man stood in no need of the
violent revolution in mode of life implied in conver-
sion. A gradual process of development led to his
feeling that although to labour was to pray, there was
a need for more attention to the spiritual, even in his
self-sacrificing life.
206
FAILING HEALTH— DEATH
There is evidence that during a brief period of his
career Simpson became affected by speculative doubts ;
indeed it v^^ould have been surprising if his mind had
not been affected by some of the nevv^ schools of thought
which sprang up in the footsteps of Charles Darwin,
and appeared for a time to threaten a mortal antagonism
to all that was dear to orthodox Christians. But these
did not influence him long ; true to his character he
examined every new thought and finding it wanting
remained firm in his old and tried faith, and ranged
himself on the side of those who perceived nothing
seriously incompatible between religion and modern
science.
In his bearing, when the angel of sorrow afflicted his
household with no unsparing hand, we find him always
a religious-minded man. The first trial was the loss
of the eldest child, his daughter Maggie, in 1844.
Another daughter, Mary, was lost in early infancy.
In 1848 his friend of boyhood and student days.
Professor John Reid, was smitten with a painful
malady and died after a prolonged period of suffering
during which, knowing that the shadow of death was
hanging over him, he devoted himself in retirement
to religious thoughts. Experiences such as these made
Simpson pause and question himself. Brimful of life
and vigour, however much he came in contact with
death in his professional rounds, the sight of it in
his own inner circle powerfully stirred his emotional
nature. His friend the Rev. Dr. Duns noticed in
207
SIR JAMES SIMPSON
him after these sad events a gradually increasing
earnestness in his spiritual life, and a closer inquiry into
the meanings of the Scriptures. He sought out the
company, and placed himself under the influence of
those among his patients whom he knew to possess
fervid religious temperaments. The last mental stum-
bling-block was the question of prayer ; he had seriously
doubted in examining the question intellectually that
human prayer could influence the purpose of the
Deity. It is difficult, if not presumptuous, to inquire
into the process whereby, under the guidance of
spiritually minded friends, his doubts were satisfied.
"... One indeed I knew
In many a subtle question versed."
' He fought his doubts and gathered strength,
He would not make his judgment blind,
He faced the spectres of the mind,
And laid them — thus he came at length"
*****
' To find a stronger faith his
own,
The simple earnest faith of his fathers in which he
had commenced life, ran all through his mature years
and prompted his strong purposeful energies. After
the combat with the only seriously perplexing doubt
he re-embraced his faith with the simplicity of a child
and the strength of a giant. For one accustomed
to apply to every subject taken in hand the rigid
process of careful scientific investigation, it required
208
FAILING HEALTH— DEATH
no small effort to lay aside his usual methods and
suffer himself to be led wholly by faith.
It was impossible for Simpson to enter into any
movement without taking a prominent part in it.
That Christmas Day on which all doubts left him was
followed by days of extraordinarily zealous work, such
as would have been expected of him after he had
convinced himself that he had a mission to spread
abroad this, the latest, and, in his opinion, the greatest,
of his discoveries. He plunged at once into the midst
of Evangelical societies, missions, and prayer-meetings,
amongst the upper and lower classes of Edinburgh,
and made excursions into the mining districts of his
native county to deliver addresses. He interested
himself in the education of theological students, and
in foreign missions, and added to his literary work the
writing of religious addresses, tracts and hymns. His
example had a powerful influence in Edinburgh. It
is said that he frequently addressed on a Sunday
evening Evangelical assemblies of two thousand
persons. The news of his so-called conversion was
gleefully spread by well-meaning folks, who had given
credence to statements published by his enemies, and
imagined that here was a bad if a great man turned
aside from the broad to the narrow path. This
enthusiastic revival movement died down in time, and
Simpson returned to his ordinary everyday life.
More sorrow soon fell to his lot. In 1862 his fifth
child, James, who had always been an invalid, was
209 p
SIR JAMES SIMPSON
taken from him at the age of fifteen. In 1866 the
sad death of Dr. David Simpson, the eldest son, which
has already been referred to, was followed in about a
month's time by that of the eldest surviving daughter,
Jessie, at the age of seventeen. The death of James,
a sweet-natured child, stimulated him in the revival
work. Pious friends had surrounded the little sufferer
and led him to add his innocent influence in exciting
his father's rehgious emotions.
There is reason to believe that Simpson perceived
much insincerity in the revival movement, and
attempted to dissociate himself from active partici-
pation in it, on account of finding it impossible to
work in harmony with some who, though loud in
profession, flagrantly failed in practice.
The subject of Simpson's health has been little
referred to in these pages, because throughout his life
he paid little attention to it. The chief remedy for
the feeling of indisposition v/as change of work. He
found it impossible to be idle, and sought as recreation
occupations such as archaeological research, or a
scamper round foreign hospitals, which to most people
would have savoured more of labour. The part of his
body which was most worked, his nervous system, was
naturally the one which most often troubled him with
disorder ; like other great men of high mental de-
velopment he suffered from time to time with severe
attacks of megrim, which necessitated a few hours of
rest. The blood-poisoning, for which he availed him-
210
FAILING HEALTH— DEATH
self of Professor Syme's services, was soon recovered
from with prompt treatment ending in a foreign tour ;
but after it little illnesses became more frequent, and
he was perforce occasionally confined to the house.
During these times he busied himself, for the sake of
occupation and to distract his attention from his suffer-
ings, in professional reading or the preparation of literary
papers. Rheumatic troubles became frequent, and
soon after his eldest son's death he had to run over to
the Isle of Man to free himself from a severe attack of
sciatica.
Long, weary nights spent at the bedside of
patients or in tiresome railway journeys, and exposure
to all varieties of weather, had a serious effect upon
him. Travelling was slow, according to modern ideas,
and long waits at wayside stations in winter-time
helped to play havoc with his constitution. He was
well known to the railway officials in Scotland. The
figure of the great Edinburgh professor was familiar
at many a station, striding up and down the platform
with the stationmaster, chaffing the porter, or cheerily
chatting to the driver and stoker leaning out of the
engine. After his death many of these men would
proudly produce little mementoes of their services to
him, which he never forgot to send.
The little rest house, Viewbank, on the Forth, had
to be more frequently sought refuge in, if only to get
away from the harassing night-bell and secure a full
night's sleep. In the last year or two of his existence
211
SIR JAMES SIMPSON
he found the work of his practice and chair hard to
carry on, not because of any defined illness, but on
account of the loss of that buoyant elasticity of consti-
tution which had enabled him to bear without apparent
effort or injury the fatigue which would have been suffi-
cient to prostrate more than one ordinary man. He
had early trained himself to do with a minimum of
sleep ; to snatch what he could and when he could, if
it were only on a sofa, a bare board, or in one of the
comfortless railway carriages of the day. He took full
advantage during his career of the modern facihties for
traveUing which he had seen introduced and deve-
loped. Many a night was spent in the train, going
to or returning from a far-distant patient, or after a
combined professional and archaeological excursion ;
the next morning would find him busy in his usual
routine. On the day after receiving the degree of
D.C.L. at Oxford in 1866, he started for Devizes,
which was reached the same evening 5 here he had a
hasty meal and drove on to Avebury to see the standing
stones there. He returned at midnight, and at five
o'clock next morning set off for Stonehenge, a place
he had long desired to see, thoroughly examined the
remarkable remains, and on his return took train to
Bath, where he found time to examine more antiquities.
At midnight a telegram reached him calling him pro-
fessionally to Northumberland. He snatched a few
hours' sleep, and taking the four a.m. train to London
set out for Northumberland, where he saw his patient,
212
FAILING HEALTH— DEATH
and then proceeded to Edinburgh. This is no solitary
instance of his journeyings, but an example of many.
When the year 1870 had been entered upon, he
awoke to the fact that his flesh was too weak for his
eager spirit ; despite this, he held on his course, and
worked without ceasing, never refusing an urgent call,
although he now suffered from angina pectoris. On
February 12th he hastened to London to give evidence
in a notorious divorce case. He arrived only to find
that the trial had been postponed for four days. He
returned to Edinburgh on the 14th, spent the next
day in professional visits in the country, and arrived
again in London in time to appear in the witness-box
on the 1 6th, although chilled to the bone by the cold-
ness of the long journey. On the following day he
stopped at York on his way home, dined with Lord
Houghton, and visited, at 1 1 p.m., his friend Dr.
Williams, in Micklegate. During the remainder of
the journey from York to Edinburgh he suffered
severely, and " was glad to rest for awhile upon the
floor of the railway carriage."
A few days after this last run to London he was
summoned to see a patient in Perth, but was this time
so fatigued by the effort, that after his return on
February 25th he was obliged to take to bed. The
news sped to all quarters cf the globe that Simpson was
gravely ill, for nothing but grave illness could compel
that vigorous man to completely lay down his work.
His symptoms improved at first under appropriate
213
SIR JAMES SIMPSON
treatment sufficiently to allow him to be placed on a
bed in the drawing-room ; and he even once more
took up his favourite archaeology, revising some of his
work in that subject. Patients also were not to be
denied ; many were seen and prescribed for in his
sick room, some even being carried up to his presence.
But the fatal disease regained ascendancy, and the
fact became apparent to all, not excepting himself,
that the last chapter of the closely written book of his
life had been entered upon. Towards the end of
March, by his own request, his eldest surviving son
was telegraphed for to be near him, and he wrote a
touching letter to his youngest son, then a student in
Geneva, encouraging him in his studies, asking him to
look for cup-markings cut in the curious islet rock in
Lake Geneva, and ending with an expression of his
feeling of impending death, for which he felt perfectly
and happily prepared. In these last days he loved to
have his nearest and dearest around him ; Lady Simp-
son and others read to him, and his daughter tells us
how she daily prepared her school lessons in the sick
room with his help ; to the last he interested himself
in the work of his relations and friends. He answered
the attack of Bigelow, of Boston, conscious that it
was his last effort on behalf of chloroform, and wrote
to all his old opponents asking their forgiveness if at
any time words of his had wounded their feelings.
He might well have spared himself the regrets — such
as they were — which troubled him. '^ I would have
214
FAILING HEALTH— DEATH
liked to have completed hospitalism," he said, " but I
hope some good man will take it up." On another
occasion he asked, " How old am I ? Fifty-nine ? Well,
I have done some work. I wish I had been busier."
He expressed a desire that his nephew should suc-
ceed him in the Chair of Midwifery — he would, he
thought, help to perpetuate his treatment.
There was much communing with himself on his
future, and all his sayings on the subject breathed the
simple faith first inculcated in him in the Bathgate
cottage. His great sufferings, sometimes allayed by
opiates and his own chloroform, were bravely borne,
but the days dragged sadly on. On the evening of
May 5th Sandy took his place at his side, and the last
conscious moments of the great physician were spent
with his head in the arms of him who had helped
and guided him through the difficult days of his
career. At sunset on May 6th he passed peacefully
away.
The extent of the feeling evoked by the tidings of
his death was represented in Mr. Gladstone's remark
that it was a grievous loss to the nation and was truly
a national concern. There was a universally ex-
pressed opinion that he merited without a shadow of
doubt the rare national honour of public interment in
Westminster Abbey. A committee was formed out of
the leading medical men in London to carry out this
suggestion. Their task was light, for the Dean
acceded to the request at once. Much as his
215
SIR JAMES SIMPSON
family and the Scots people valued this tribute to his
greatness, they decided otherwise. Scotland has no
counterpart of Westminster in which to lay to rest
those whom she feels to have been her greatest ; but
Edinburgh felt that she could not part with him who
in life had been her possession and her pride. He had
long ago chosen a piece of ground in the Warriston
cemetery, and Lady Simpson decided, to the gratifica-
tion of his fellow-citizens, that he should be buried
there beside the five children who had preceded him.
His resting place was well chosen ; it nestled into the
side of the beautiful city, and from it could be viewed
some of the chief objects of the scene he knew so
well — on the south the stately rock crowned with
the ancient castle, and the towering flats of the old
town stretching away to Arthur's Seat ; on the north
the long stretch of the Firth of Forth and in the
distance on the one hand the Ochills ; on the other
the Bass Rock.
The funeral was one of the most remarkable ever
witnessed in Scotland. It took place on May 13th
in the presence of a crowd estimated to consist of
thirty thousand persons. The hearse was followed by
a representative procession comprising close upon two
thousand persons. His own relatives assembled at 52,
Queen Street, the general public and the Town
Council in the Free Church of St. Luke, and the
representatives of the University, the Colleges of
Physicians and Surgeons, and the Royal Society and
216
FAILING HEALTH— DEATH
many other public bodies, in the Hall of the College of
Physicians. At each of these meeting-places religious
services were held. The whole city ceased to labour
that afternoon in order to pay the last tribute to its
deirly loved professor. The poor mourned in the
crowd as deeply and genuinely as those with whom
he had been closely associated in life mourned as
they followed his remains in the procession. Every
mourner grieved from a sense of personal loss, so
deeply had his influence sunk down into the hearts
of the people.
The companion of his troubles and his triumphs,
who had bravely joined- him to help him to the fame
he strove after, was soon laid beside him. Lady
Simpson died on June 17th of the same year.
But two notes were struck in the countless obituary
notices and letters of condolence which appeared from
far and near — those of appreciation of his great
nature, and sorrow for the terrible loss sustained by
science and humanity. The Queen caused the Duke
of Argyle to express to the family her own personal
sorrow at the loss of " so great and good a man." A
largely attended meeting was held in Washington
to express the feeling of his own profession in the
United States, at which Dr. Storer moved, " that in
Dr. Simpson, American physicians recognise not
merely an eminent and learned Scots practitioner, but
a philanthropist whose love encircled the world ; a
discoverer who sought and found for suffering
217
SIR JAMES SIMPSON
humanity in its sorest need a foretaste of the peace
of heaven, and a devoted disciple of the only true
physician, our Saviour Jesus Christ."
The following original verses from the pen of a
well-known scholar in the profession, were given
prominence in the columns of the Lancet : —
PROMETHEUS.
(Our lamented Sir James Simpson was the subject of angina pectoris.)
'Alas ! alas ! pain, pain, ever forever ! "
So groaned upon his rock that Titan good
Who by his brave and loving hardihood
Was to weak man of priceless boons the giver,
Which e'en the supreme tyrant could not sever
From us, once given ; we own him in our food
And in our blazing hearth's beatitude ;
Yet still his cry was " Pain, ever forever ! "
Shall we a later, harder doom rehearse ?
One came whose art men's dread of art repressed :
Mangled and writhing limb he lulled to rest,
And stingless left the old Semitic curse ;
Him, too, for these blest gifts did Zeus amerce ?
He, too, had vultures tearing at his breast.
Hush, Pagan plaints ! our Titan is unbound j
The cruel beak and talons scared away ;
As once upon his mother's lap he lay
So rests his head august on holy ground ;
Spells stronger than his own his pangs have found ;
He hears no clamour of polemic fray,
Nor recks he what unthankful men may say ;
Nothing can vex him in that peace profound.
2l8
FAILING HEALTH— DEATH
And where his loving soul, his genius bold ?
In slumber ? or already sent abroad
On angels' wings and works, as some men hold ?
Or waiting Evolution's change, unawed ?
All is a mystery, as Saint Paul has told,
Saying, "Your life is hid with Christ in God."
In a peaceful corner of the St. Andrew Chapel in
Westminster Abbey, alongside memorials of Sir Hum-
phry Davy and a few other scientists of note, stands a
speaking image in marble — perhaps the most expressive
representation that exists — of this wonderful man.
"To whose genius and benevolence
The world owes the blessings derived
From the use of chloroform for
The relief of suffering.
Laus Deo."
Mr. Jonathan Hutchinson, when writing to the
medical journals in support of the proposal to secure
Simpson's burial in Westminster Abbey, foretold that
his reputation would ripen with years, that jealousies
would be forgotten, and antagonism would be buried.
Twenty-seven years have elapsed since then, and
few remain with whom he came in conflict ; those
who do remain exchanged, along with others of his
opponents, friendly words of reconciliation in the end,
and took the hand which he held out from his death-
bed. As a man, Simpson had his faults ; but they
were exaggerated in his Hfetime by some, just as his
capabilities and achievements were magnified by
219
SIR JAMES SIMPSON
those who worshipped him as inspired. He was full
of sympathy for mankind, benevolent and honest to a
fault, and forbearing to his enemies. He rushed
eagerly into the combat and oftentimes wounded sorely,
and perhaps unnecessarily. His genius was essen-
tially a reforming genius, and impelled him to fight
for his ends, for genius is always the "master of man."
We can forgive him if sometimes it caused him to
fight too vigorously, where the heart of a man of
mere talent might have failed and lost. His social
charms were excelled only by his marvellous energy,
his prodigious memory, and his keenness of insight ;
but he was regrettably inattentive to the details of
ordinary everyday life and practice.
He approached the study of medicine when the dark-
ness of the Middle Ages was still upon it, and was one
of the first to point out that although many diseases
appeared incurable, they were nevertheless preventable.
Although no brilliant operator himself, he so trans-
formed the surgical theatre by his revelation of the
power of chloroform, and by his powerful advocacy of
the use of anaesthetics, that pain was shut out and vast
scientific possibilities opened up ; many of which have
been brilliantly realised by subsequent workers. He
devoted himself specially to the despised obstetric art,
fighting for what he recognised as the most lowly
and neglected branch of his profession, ranging his
powerful forces on the side of the weak, and left
it the most nearly perfect of medical sciences.
220
FAILING HEALTH— DEATH
He was enthusiastic in his belief in progress, and in
the power of steady, honest work to effect great ends.
With the exception of the time of that temporary burst
into revivalism in 1861, his motto throughout life
might very well have been lahorare est orare. He
was no believer in speculations, but curiously enough
kept for recreation only the subject of archaeology,
in which he entered into many intricate speculative
studies. In his professional work he avoided specu-
lation, and never adopted a theory which was not
built upon firm fact.
If we are asked for what we are most to honour
Simpson, we answer, not so much for the discoveries he
made, not for the instruments he invented, not for his
exposure of numerous evils, not for the introduction
of reforms, not for any particular contribution to
science, literature, or archaeology ; but rather for
the inspiring life of the man looked at both in outline
and in detail. He was guided by high ideals, and a
joyous unhesitating behef that all good things were
possible — that right must prevail. He was stimulated
by a genius which, as has been pointed out, gave him
the energy to fight for his ends with herculean
strength. The fact that chloroform was by his
efforts alone accepted as the anaesthetic, and ether,
which from the first was generally thought to be
safer in ordinary hands, was deliberately put on one
side practically all over the world, testified to his
forcible and convincing method, and to his power of
221
SIR JAMES SIMPSON
making others see as he saw. As a man of science
alone, as a philanthropist alone, as a worker alone,
as a reformer alone, he was great. But although to
the popular mind he is known chiefly because of his
introduction of chloroform, medical history will record
him as greater because of his reforming genius, and
will point to the fight for anaesthesia, and his crusade
against hospitalism as the best of all that he accom-
plished or initiated. And he who, while making
allowances for the weaknesses of human nature which
were Simpson's, studies the life which was brought
all too soon to a close, will recognise the great spirit
which breathed through all his life.
THE END.
222
APPENDIX
I.
The following is a list of Sir James Simpson's con-
tributions to Arckaology. His professional writings, in the
form of contributions to the medical journals, or of papers
read to various societies or meetings, number close upon
two hundred.
1. "Antiquarian Notices of Leprosy and Leper Hos-
pitals in Scotland and England." (Three papers read
before the Medico-Chirurgical Society, March 3, 1841.)
Edinburgh Medical and Surgical Journal^ October, 1841,
and January and April, 1842.
2. "Notice of Roman Practitioner's Medicine Stamp
found near Tranent." Royal Society of Edinburgh ; Dec.
16, 1850.
3. "Ancient Roman Medical Stamps." Edinburgh
Journal of Medical Science^ Jan., March, April, 185 1.
4. " Was the Roman Army provided with any Medical
Officers?" Edinburgh, 185 1, private circulation.
5. "Notes on some Ancient Greek Medical Vases for
containing Lykion ; and on the modern use of the same
in India." Edinburgh, 1856.
223
APPENDIX
6. " Notice of the appearance of Syphilis in Scotland
in the last years of the fifteenth century." i860.
7. " Note on a Pictish Inscription in the Churchyard of
St. Vigeans." Royal Society, April 6, 1863.
8. "Notes on some Scottish Magical Charm-Stones or
Curing Stones." Proceedings of Antiquarian Society of
Scotland^ vol iv., 1868.
9. " An Account of two Barrows at Spottiswoode, Ber-
wickshire, opened by the Lady John Scott." Proceedings
of Antiquarian Society of Scotland, vol iv., 1868.
10. "Did John de Vigo describe Acupressure in the
Sixteenth Century ? " British Medical Journal, Aug. 24,
1867 ; Medical Tifnes and Gazette, 1867, vol. ii., p. 187.
1 1. "Account of some Ancient Sculptures on the Walls
of Caves in Fife." 1867.
12. "Notices of some Ancient Sculptures on the Walls
of Caves." Proceedings of the Royal Society ; Edinburgh,
1867.
13. "Cup-cuttings and Ring-cuttings on the Calder
Stones, near Liverpool." 1866. Transactions of the His-
torical Society of Lancashire and Cheshire.
14. "Archaeology — its past and its future work." An-
nual Address to the Society of Antiquarians of Scotland,
January 28, 1861.
15. "The Cat Stane, Edinburghshire." Proceedijigs of
the Society of Antiquaries, Scotland, 1861.
16. "Archaic Sculpturings of Cups, Circles, &c., upon
Stones and Rocks in Scotland, England, and other
countries." 1867.
17. "Is the Pyramid at Gizeh a Meteorological Monu-
ment ? " Proceedings of the Royal Society ; Edinburgh,
1868.
18. "Pyramidal Structures in Egypt and elsewhere."
Proceedings of the Royal Society ; Edinburgh, 1868.
19. " Cell at Inchcolm."
224
APPENDIX
The above list is founded on that given by Professor
Gusserow in his " Zur Erinnerung an Sir James Y.
Simpson." Berlin, 1871.
II.
On post mortem examination the following observations
on Sir James Simpson's head were made : —
Skull — circumference round by occipital protuberance
and below frontal eminences, 22^ inches.
— from ear to ear, 1 3 inches.
— from occipital protuberance to point between
superciliary ridges, 13 inches.
Brain — weight of entire brain (cerebrum and cerebellum)
was 54. ounces ; the cerebellum, pons, and me-
dulla oblongata weighed ^\ ounces.
The convolutions of the cerebrum were remarkable for
their number, depth, and intricate foldings. This was
noticed more particularly in the anterior lobes and the
islands of Reil.
Extract from British Medical Jourfial, May 14, 1870.
225
INDEX
Academy of Sciences
(France), 194
Acupressure, 173
Adam Street, Simpson's
lodgings in, 20, 30
Addresses, Graduation, 74-
77, 200
Alcohol as an anaesthetic, 93
Alison, Professor, 56, 59,
America, United States of,
and anaesthesia, 83, 96,
199
Anaesthesia, 88, 178; oppo-
sition to: (i) medical,
113 ; (2) moral, 120 ;
(3) religious, 123. Dis-
covery of, 88 ; results of
130
Antiquarians, Scots Society
of, 8, 71, 156
Appendix, 223
Archaeological works, Simp-
son's, 223
Archaeology, 4, 8,-'l52, 223
Argyle, Duke 'of, 217
Arts, curriculum of, 14, 19,
20
Aytoun, 27
B
Baden, Princess Marie or,
69
Ballingall, Professor, 60
Baronetcy, Simpson's, 190
Bathgate, 4, 7, 8, 34, 142
Bell, Sir Charles, 60, 61
Bennet, 42
Bigelow, Dr., of Boston,
198, 214
Blantyre, Lord, 80
Boerhaave, 134
Boston, U.S.A., 97, 98, 199
Braid, Dr., 95
Brewster, Sir David, 27, 192
227
INDEX
British Medical Association,
i88
British Medical Journal, 1 76,
177, 188, 225
Bruce, Robert, 72
Brunton, Dr. Lauder, 148
Burke and Hare, 23
Bursary won by Simpson, 20
Carstares, William, 192
Catstane, the, of Kirkliston,
8, 155
Chalmers, Dr., 27, 125
Cheselden, 122
Cheyne, Mr. Watson, 1 84
Children, Simpson's, 85,
207
Chirurgeons, incorporation
of, 58
Chloric ether, 99
Chloroform, 215, 221,219;
discovery of, 105 ; com-
position described by
Dumas, 106 ; Flouren's
experiments, 106 ; dis-
covery of properties,
106 ; used in obstetrics,
108 ; Simpson's opinion
of, III ; administration,
teaching of, 130
Christison, Professor, 56, 59,
84, 148, 188, 195
Clark, Sir James, 129
Clover, 130
Cockburn, Lord, 23, 27
College of Physicians, Edin-
burgh, 53. 58, 189
Cooley, Mr., 97
Cooper, Bransby, 123
Crest, Simpson's, 192
Cullen, 2, 27, 41
D
Davy, Sir Humphry, 95, 96,
219
Dawson, Dr., 69
De Quincey, 127, 128
Disruption, the, 85
Doctor of Medicine, degree
of, 38
Dumas, 106
Dunbar, Professor, 18
Duncan, Dr. Matthews, 105
Duns, Dr., 34, 162, 196,
207
Du Potet, 94
Edinburgh, 17, 27, 197
Edinburgh Medical and Sur-
gical Journal, 52, 72
Education, Simpson on, 199
Elliotson, Dr. John, 94, 95
Encyclopedia Brita?inica, 198
Erskine House, Simpson's
visit to, 80
228
INDEX
Esdaile, Dr., 95
Ether, 99, 104, 112
Evangelical work, Simpson's,
209
Extramural Medical School,
Edinburgh, 26, 31
Faraday, 96
Fohman, Professor, 45
Forbes,' Edward, 4 1
Foreign tour, Simpson's,
43-46
Free Church, 85
Freedom of Edinburgh city,
197
Funeral, Simpson's, 216
Gairdner, Dr., 37
Girdwood, Dr., 37
Gladstone, Mr., 215
Goodsir, Professor, 42
Graduation addresses, 74-
77, 200
Graham, Professor R., 59,
148
Grant, Sir Alexander, 195
Gregory, Dr., 32, 33
Grindlay, Miss Jessie, 46,
55, 57
Grindlay, Mr., 46, 61, 68
Gusserow, Professor, 113,
170, 225
229
Gynsecological Society of
Boston, 199
Gynaecology, 86
H
Hahnemann, 147
Hamilton, Duchess of, 69
Hamilton, Professor James,
32, 40, 56, 59, 69, 163,
169
Hamilton, Sir William, 27
Health, Simpson's, 210
Henderson, Professor, 148
Home, Professor James, 59
Homoeopathy, 74, 147
Hope, Thomas, 56, 59
Hospitalism, 177-184
Hospitality, Simpson's, 81-
83
Hotels, the Edinburgh, and
Simpson, 163
Houghton, Lord, 213
Hutchinson, Mr. Jonathan,
219
Hypnotism, 94, 149
Imperial Academy of Medi-
cine (France), 189
Indian hemp, 92
Infirmary, Royal, of Edin-
burgh, 31, 109, 177, 178,
187
INDEX
J
ackson, Dr., of Boston,
U.S.A., 96
James VI., 192
Jameson, Professor R., 59
JefFery, Lord, 27
Jenner, 119, 145
K
Keiller, Dr., 30
Keith, Dr. George, 105
Kennedy, Dr. Evory, 61,63
Knox, Robert, 23, 24, 25,
26, 28
Lancet^ the, ,95, 169, 191,
218
Laughing-gas, vide nitrous
oxide
Laycock, Professor, 186
Leighton, Archbishop, 193
Leprosy and leper-houses,
70
Lippi, 45
Lister, Lord, 176, 179, 184,
188
Liston, Professor, 26, 31,
91, 95, 104, 151
Lizars, John, 26
London, Simpson's journeys
to, 80, 187, 213
Long, Dr., ot Athens,
U.S.A., 96
Lycium, the, of the Muses,
154
M
MacArthur, Mr., 20, 21,
22, 26, 39
Macintosh, Dr., 55
Maclagan, Sir Douglas, 43
Maclaren, Mr. Duncan, 61
Maga, the university, 41
Mandrake, 93
Master of Arts, the degree
of, 19
Medical faculty, the, 57, 59,
60, 187
Medical Reform Act, the,
187
Medical student, the Edin-
burgh, 33
Medical Times and Gazette^
the, 184
Medicine, condition of, at
Simpson's birth, 1-3
Medico-Chirurgical Society,
the Edinburgh, 189
Meigs, Proressor, 117
Melbourne, Lord, 28, 73
Mesmerism, 94, 149
Midwifery, 3, 32, 39, 40,
53, 86, 104
Midwifery Chair, 55-65
188, 215
230
INDEX
Midwifery class, Simpson's
67
Miller, Professor, 106, 109,
186
Moncrieff, Lord, 27
Monro (Primus), 57
Monro (Secundus), 56
Monro (Tertius), 23, 59
Montgomery, Dr., 140
Monthyon Prize, the, 190
Morton, W. T. G., 97, 98,
129, 132, 198
N
Napier, Lord, ot Magdala,
Nepenthe^ 93
Newhaven, 143, 196
Nitrous oxide gas, 97
North, Christopher, 18
Nunn, Mr., 123
O
Oineromathic, the Society,
42
Oxford, D.C.L., degree of,
192, 212
Pare, Ambroise, 90
Pathology, 39, 53, 55, 73,
74
Petroleum, 84
Physician-Accoucheur tothe
Queen,Simpson appointed
86
Pillans, Professor, 18
Post mortem, 225
Practitioner, the, 184
Principalship, the, of Edin-
burgh University, 192
" Prometheus," 218
"Puck," 138
Q
Queen Street, No. 52. 78,
81, 105, 137
Queen, the, 17, 86, 129,
190
R
Reform, medical, 187
Reform, university, 187
Regents, the, of Edinburgh
University, 192
Reid, Professor John, 18,
20, 21, 22, 25, 26, 39,
41,42, 55, 207
Religious views, Simpson's,
203
Rinderpest, epidemic of,
185
Rollock, the Regent, 192
Roman army, the, 156
Royal Medical Society, 41,
52» 53
2?I
INDEX
Royal Physical Society, 41 j St. Bartholomew's Hospital,
Russell, Lord John, 27, 151
9^ Stevenson, R. L., 80
Storer, Dr., 217
Student, the Edinburgh
medical, 33
Superstitions, 4, 5, 12
Surgery at Simpson's birth,
3 ; before anaesthesia, 88-
91 ; after anaesthesia, 131
Sutherland, the Duchess of,
80, 86
Scots Observer, the, 82
Scotsman, the, 61, 142
Scott, Sir Walter, 27, 124
Senatus Academicus, the, of
Edinburgh University, 29,
186, 194
Simpson, Alexander, 10,37, I ^^"^^' ^^^^^^sor, 26, 31,60,
40, 61, 205, 215
Simpson, David, 5
Simpson, David (secundus),
37
Simpson, David (tertius),
191, 210
Simpson, Lady, 191, 216,
217
Simpson, Mary, 10
Simpson, Miss E. B., 138,
202, 214
Simpson, Mrs., 5, 6, 204
Simpson, Professor A. R.,
51, 86, 164, 219
Smallpox, 184
Snow, Dr., 130
Snowball riot, the, 42
Sound, the, 168
Squabbles, Simpson's, 78
Stafford House, Simpson's
visit to, 80
61, 73, 114, 175, 130,
140, 148, 151, 186
Thatcher, Dr., 37, 63
Thesis, Simpson's, for M.D.
degree, 39
Thomson, Professor, 39, 60,
72
Town council of Edinburgh,
the, 28, 58, 60, 63, 65,
73, 188, 192
Traill, Professor, 60
U
Universities (Scots) Act,
188, 193
University of Edinburgh, 14,
18, 26, 28, 31, 130
232
INDEX
Verses, Simpson's, 33, 202
Viewbank, 143, 211
W
Waldie, Mr., 105
Wallace, Professor, 18
Warren, Dr. J. Collins, 102
Warriston cemetery, 216
Weavers, the, of Bathgate,
8.9
Wells, Horace, 97, 132, 198
Wesley, John, 71
Westminster Abbey, 215,
219
Williams, Dr., of York, 213
Wilson, George, 42
Wilson, Professor John, 18,
27
Women, medical, 188
Wound-healing, 176
York, Simpson's visit to,
213
Young, Professor Thomas,
59
233
Zb& Grcsbam iprcss,
UNWIN BBOTHEBS,
WOKING AND LONDON.
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